Compounds that inhibit Mcl-1 protein

ABSTRACT

Provided herein are myeloid cell leukemia 1 protein (Mcl-1) inhibitors, methods of their preparation, related pharmaceutical compositions, and methods of using the same. For example, provided herein are compounds of Formula I,or a stereoisomer thereof; and pharmaceutically acceptable salts thereof and pharmaceutical compositions containing the compounds. The compounds and compositions provided herein may be used, for example, in the treatment of diseases or conditions, such as cancer.

CROSS REFERENCES TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No. 62/547,589, filed on Aug. 18, 2017, which is hereby incorporated by reference in its entirety and for all purposes as if fully set forth herein.

FIELD OF THE INVENTION

The present invention relates to compounds that inhibit myeloid cell leukemia 1 protein (Mcl-1, also abbreviated as MCl-1, MCL-1 or MCL1); methods of treating diseases or conditions, such as cancer, using the compounds; and pharmaceutical compositions containing the compounds.

BACKGROUND OF THE INVENTION

One common characteristic of human cancer is overexpression of Mcl-1. Mcl-1 overexpression prevents cancer cells from undergoing programmed cell death (apoptosis), allowing the cells to survive despite widespread genetic damage.

Mcl-1 is a member of the Bcl-2 family of proteins. The Bcl-2 family includes pro-apoptotic members (such as BAX and BAK) which, upon activation, form a homo-oligomer in the outer mitochondrial membrane that leads to pore formation and the escape of mitochondrial contents, a step in triggering apoptosis. Antiapoptotic members of the Bcl-2 family (such as Bcl-2, Bcl-XL, and Mcl-1) block the activity of BAX and BAK. Other proteins (such as BID, BIM, BIK, and BAD) exhibit additional regulatory functions.

Research has shown that Mcl-1 inhibitors can be useful for the treatment of cancers. MCl-1 is overexpressed in numerous cancers. See Beroukhim et al. (2010) Nature 463, 899-90. Cancer cells containing amplifications surrounding the Mcl-1 and Bcl-2-1-1 anti-apoptotic genes depend on the expression of these genes for survival. Beroukhim et al. Mcl-1 is a relevant target for the re-iniation of apoptosis in numerous cancer cells. See G. Lessene, P. Czabotar and P. Colman, Nat. Rev. Drug. Discov., 2008, 7, 989-1000; C. Akgul Cell. Mol. Life Sci. Vol. 66, 2009; and Arthur M. Mandelin II, Richard M. Pope, Expert Opin. Ther. Targets (2007) 11(3):363-373.

New compositions and methods for preparing and formulating Mcl-1 inhibitors would be useful.

SUMMARY OF THE INVENTION

1. One embodiment of the present invention comprises a compound of Formula I:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof, wherein:

Z is C or N;

b, represented by the symbol

, is a single or double chemical bond which may be cis or trans;

R¹ is independently selected from H, halo, C₁₋₆alkylhalo, C₁₋₆alkyl, C₂₋₆alkenyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), or —C(═O)NR^(a)R^(b);

R² is selected from H, halo, C₁₋₆haloalkyl, —C₁₋₆alkyl, —O—C₁₋₆alkyl, —C₂₋₆alkenyl, —C₂₋₆alkynyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), —C(═O)NR^(a)R^(b), a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, or a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl or heterocycloalkyl group have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may include a C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂;

R³ is selected from H, —C₁₋₆alkylhalo, —C₁₋₆alkyl, —C₂₋₆alkenyl, —(CH₂CH₂O)_(n)R^(a), —C(═O)R^(a), —C(═O)OR^(a), or —C(═O)NR^(a)R^(b);

each of R^(2B), R^(2C), R⁴, R⁵, R⁶, R⁷, and R⁸ is independently selected from H, halo, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —O—C₁₋₆alkyl, —C₂₋₆alkenyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), —C(═O)NR^(a)R^(b), a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may include a C═O group, and further wherein the spiroheterocycloalkyl and heterocycloalkyl groups may include a S═O or SO₂;

alternatively R³ and R⁴ together with the atoms to which they are bonded may form a 5- to 12-membered ring, optionally containing a heteroatom selected from a N, O or S atom, in addition to the S and N atoms present in the ring, wherein the ring may optionally contain at least one double bond; and the ring may be substituted with 0, 1, 2, or 3 R^(3A) substituents;

wherein R^(3A) is selected from H, halo, —OH, C₁₋₆haloalkyl, C₁₋₆alkyl, O—C₁₋₆alkyl, C₂-6alkenyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), or —C(═O)NR^(a)R^(b);

each of R^(4A), R^(5A), R^(6A), R^(7A), and R^(8A) is independently selected from H, OH, halo, or —C₁₋₆alkyl;

R^(7A) and R^(8A) are absent when b is a double chemical bond;

alternatively R⁷ and R⁸ together with the atoms to which they are bonded may form a 3- to 12-membered ring, wherein the ring may optionally contain at least one double bond;

R⁹ is independently selected from H, OH, -(═O), —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkenylene, —(CH₂CH₂O)_(n)R^(a), —C(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, cyano, a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl or heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, and the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl group may include a C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂;

R^(9A) is independently selected from

R^(9B), R^(9C), R^(9D) and R^(9E) are independently selected from H, —OH, halo, cyano, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₂-C₆ alkenyl, —C₂-C₆ alkynyl, —(CH₂CH₂O)_(n)R^(a), —CS^(Ra), —CS(═O)R^(a), —SR^(a), —SOR^(a), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —(CH₂)_(n)—NR^(a)R^(b), —NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O—C₁₋₆alkyl-O—C₁₋₆alkyl, phenyl, a 6- to 12-membered monocyclic or bicyclic aryl, a 6- to 12-membered monocyclic or bicyclic heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may contain a double bond and may contain one or two C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂; and still further wherein two adjacent carbon atoms or an adjacent carbon atom and N atom on a R^(9B) heterocycloalkyl group may join together to form a 6-membered aromatic ring that is unsubstituted or is substituted with 1, 2, or 3 R¹³ groups.

wherein R^(9D) and R^(9E) together with the atoms they are bonded to, may form a 3- to 12-membered monocyclic or bicyclic ring, optionally containing 1, 2, 3 or 4 heteroatoms independently selected from N, O or S, wherein the ring may contain a double bond, wherein the ring may optionally include a C═O group, and further wherein the ring optionally may be substituted by 1, 2, or 3 R^(9F) substituents;

R^(9F) is independently selected from —OH, halo, cyano, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₂-C₆ alkenyl, —C₂-C₆ alkynyl, —(CH₂CH₂O)_(n)R^(a), —CSR^(a), —CS(═O)R^(a), —SR^(a), —SOR^(a), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —(CH₂)_(n)—NR^(a)R^(b), and —NR^(a)R^(b);

wherein the aryl, heteroaryl, cycloalkyl, heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl groups of any of the R^(9B), R^(9C), R^(9D), and R^(9E) substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹⁰ substituents independently selected from, OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, —C₂-C₆ alkenyl, —C₂-C₆alkynyl, —OC₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₁₋₆alkyl-O—C₁₋₆alkyl, C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —SO₂R¹³, —CN, —C(═O)NR^(c)R^(d), —C(═O)R^(c), —OC(═O)R^(c), and —C(═O)OR^(c);

wherein the C₁₋₆alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl and the —OC₁₋₆alkyl of any of the R′, R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, R⁹, R¹⁰, R^(4A), R^(5A), R^(6A), R^(7A), R^(8A), R^(9A), R^(9B), R^(9C), R^(9D) and R^(9F) substituents is unsubstituted or substituted by 1, 2 or 3 RH substituents independently selected from OH, —OC₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, halo, —O-haloC₁₋₆alkyl, —CN, —NR^(a)R^(b), —(NR^(a)R^(b)R^(c))_(n), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —OC(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —O—SiR^(a)R^(b)R^(c), and —SiR^(a)R^(b)R^(c);

wherein the aryl, heteroaryl, cycloalkyl, heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl group of any of the R², R⁴, R⁵, R⁶, R⁷, R⁸, and R⁹ substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹² substituents independently selected from OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, —OC₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₁₋₆alkyl-O—C₁₋₆alkyl, C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —SO₂R^(c), —CN, —C(═O)NR^(c)R^(d), —C(═O)R^(c), —OC(═O)R^(c), and —C(═O)OR^(c);

wherein each R^(a), R^(b), R^(c), and R^(d) is independently H, OH, —C₁₋₆alkyl, —C₂₋₆alkenyl, —C₂₋₆alkynyl, —C₁₋₆alkyl-NR¹³R¹³, —NR¹³R¹³, —SO₂R¹³, —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O)R¹³, —OC(═O)R¹³, —C(═O)OR¹³, —C(═O)NR¹³R¹³, —C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, benzyl, phenyl, —C₁₋₆alkyl-C(═O)OH, —C₁₋₆alkyl-C(═O)—O—C₁₋₆alkyl, —C₁₋₆alkyl-cycloalkyl, C₃₋₆cycloalkyl, and —C₁₋₆alkyl-heterocycloalkyl;

R¹³ is independently selected from H, OH, —C₁₋₆alkyl, halo, —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O-haloC₁₋₆alkyl, —CN, —N(—C₁₋₆alkyl)(—C₁₋₆alkyl), —N(—C₁₋₆alkyl)(—C₁₋₆alkyl-O—C₁₋₆alkyl), (CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)—C₁₋₆alkyl, —OC(═O), and —C(═O)O—C₁₋₆alkyl, and

wherein n is independently in each instance an integer of 1, 2, 3 or 4.

2. Another embodiment of the present invention comprises the compound of Formula IA:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof, wherein:

Z is C or N;

b, represented by the symbol

, is a single or double chemical bond which may be cis or trans;

R¹ is selected from H, halo, or C₁₋₆alkyl;

R² is selected from H, halo, or C₁₋₆alkyl;

R³ is selected from H or —C₁₋₆alkyl;

each of R⁴, R⁵, R⁶, R⁷, and R is independently selected from H, —C₁₋₆alkyl, —O—C₁₋₆alkyl, or —C₁₋₆alkyl-O—C₁₋₆alkyl;

each of R^(4A), R^(5A), R^(6A), R^(7A), and R^(8A) is independently selected from H, or —C₁₋₆alkyl;

R^(7A) and R^(8A) are absent when b is a double chemical bond;

R⁹ is independently selected from H or —C₁₋₆alkyl;

R^(9A) is independently selected from

R^(9B), R^(9C), R^(9D) and R^(9E) are independently selected from H, —OH, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —(CH₂)_(n)—NR^(a)R^(b), —NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O—C₁₋₆alkyl-O—C₁₋₆alkyl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may contain one or two C═O group, and further wherein two adjacent carbon atoms or an adjacent carbon atom and N atom on a R^(9B) heterocycloalkyl group may join together to form a 6-membered aromatic ring that is unsubstituted or is substituted with 1, 2, or 3 R¹³ groups;

wherein R^(9D) and R^(9E) together with the atoms they are bonded to, may form a 3- to 12-membered monocyclic or bicyclic ring, optionally containing 1, 2, 3 or 4 heteroatoms independently selected from N, O or S, wherein the ring may contain a double bond, wherein the ring may optionally include a C═O group, and further wherein the ring optionally may be substituted by 1, 2, or 3 R^(9F) substituents;

R^(9F) is independently selected from —C₁₋₆alkyl—or C(═O)R^(a);

wherein the heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl groups of any of the R^(9B), R^(9C), R^(9D), and R^(9E) substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹⁰ substituents independently selected from OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, or —OC₁₋₆alkyl;

wherein each R^(a), R^(b), R^(c), and R^(d) is independently H, —C₁₋₆alkyl, —C(═O)NR¹³R¹³, —C₁₋₆alkyl-O—C₁₋₆alkyl, —C₃₋₆cycloalkyl and —C₁₋₆alkyl-heterocycloalkyl;

R¹³ is independently selected from H or —C₁₋₆alkyl, and

wherein n is independently in each instance an integer of 1.

3. The compound of embodiment 1, wherein the compound has the Formula II:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

4. The compound of any of embodiments 1, 2 or 3, wherein the compound has the Formula IIa:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

5. The compound of any one of embodiments 1-4, wherein R¹ is halo.

6. The compound of embodiment 5, wherein R¹ is Cl.

7. The compound of of any one of embodiments 1-6, wherein R³ is H.

8. The compound of any one of embodiments 1-7, wherein R⁴ is independently selected from H, —C₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₁₋₆alkyl-OSO₂CH₃, —C₁₋₆alkyl-phenyl, or —C₁₋₆alkyl-(5-6 membered heterocycloalkyl, having one or two heteroatoms independently selected from N or O).

9. The compound of any one of embodiments 1-8, wherein R⁴ is independently selected from H, —CH₃, —CH₂CH₃, —CH₂—O—CH₃, or —CH₂CH₂—O—CH₃.

10. The compound of embodiment 9, wherein R⁴ is —CH₃.

11. The compound of embodiment 9, wherein R⁴ is —CH₂—O—CH₃.

12. The compound of embodiment 9, wherein R⁴ is —CH₂CH₂—O—CH₃.

13. The compound of any one of embodiments 1-12, wherein R⁵ is selected from H or —C₁₋₆alkyl.

14. The compound of embodiment 13, wherein R⁵ is —CH₃.

15. The compound of any one of embodiments 1-14, wherein R⁶ is selected from H or —C₁₋₆alkyl.

16. The compound of embodiment 15, wherein R⁶ is —CH₃.

17. The compound of embodiment 15, wherein R⁶ is H.

18. The compound of any one of embodiments 1-17, wherein R⁹ is independently selected from H, or —C₁₋₆alkyl.

19. The compound of embodiment 18, wherein R⁹ is H.

20. The compound of embodiment 18, wherein R⁹ is —CH₃.

21. The compound of any one of embodiments 1-20, wherein R^(9A) is

22. The compound of any one of embodiments 1-21, wherein R^(9B) is H, —OH, —C₁₋₆alkyl, —OCH₃, —NR^(a)R^(b), —CH₂OH,

23. The compound of embodiment 22, wherein R^(9B) is —OH.

24. The compound of embodiment 22, wherein R^(9B) is —N(CH₃)₂.

25. The compound of embodiment 22, wherein R^(9B) is —NHCH₃.

26. The compound of embodiment 22, wherein R^(9B) is —N(CH₃)—CH₂CH₂OCH₃.

27. The compound of any one of embodiments 1-26, wherein R^(9C) is H, —C₁₋₆alkyl, or —C₁₋₆alkyl-OH.

28. The compound of embodiment 27, wherein R^(9C) is H.

29. The compound of embodiment 27, wherein R^(9C) is —CH₃.

30. The compound of any one of embodiments 1-22 and 27-28, wherein

R^(9A) is

31. The compound of any one of embodiments 1-22, 28 and 30, wherein

R^(9A) is

32. The compound of any one of embodiments 1-22, 28 and 30, wherein

R^(9A) is

33. The compound of any one of embodiments 1-22, 28 and 30, wherein

R^(9A) is

34. The compound of any one of embodiments 1-20, wherein R^(9A) is

35. The compound of any one of embodiments 1-20 and 34, wherein R^(9A) is

36. The compound of any one of embodiments 1-20 and 34-35, wherein

R^(9A) is

37. The compound of embodiment 1, wherein the compound has the Formula III:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

38. The compound of any one of embodiments 1 or 37, wherein the compound has the Formula IIIa:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

39. The compound of any one of embodiments 1, or 37-38, wherein R¹ is halo.

40. The compound of embodiment 39, wherein R¹ is Cl.

41. The compound of any one of embodiments 1, or 37-40, wherein R⁴ is —C₁₋₆alkyl.

42. The compound of embodiment 41, wherein R⁴ is —CH₃.

43. The compound of any one of embodiments 1, or 37-42, wherein R⁵ is —C₁₋₆alkyl.

44. The compound of embodiment 43, wherein R⁵ is —CH₃.

45. The compound of any one of embodiments 1, 37-44, wherein R⁶ is H.

46. The compound of any one of embodiments 1, 37-45, wherein R⁹ is H.

47. The compound of any one of embodiments 1, 37-46, wherein R^(9A) is

48. The compound of embodiment 1, wherein the compound has the Formula IV:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

49. The compound of any one of embodiments 1 or 48, wherein the compound has the Formula IVa:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.

50. The compound of any one of embodiments 1, or 48-49, wherein R¹ is halo.

51. The compound of embodiment 50, wherein R¹ is Cl.

52. The compound of any one of embodiments 1, or 48-51, wherein R⁴ is —C₁₋₆alkyl.

53. The compound of embodiment 52, wherein R⁴ is —CH₃.

54. The compound of any one of embodiments 1, or 48-54, wherein R⁵ is —C₁₋₆alkyl.

55. The compound of embodiment 54, wherein R⁵ is —CH₃.

56. The compound of any one of embodiments 1, or 48-55, wherein R⁶ is H.

57. The compound of any one of embodiments 1, 48-56, wherein R⁹ is H.

58. The compound of any one of embodiments 1, 48-57, wherein R^(9A) is

59. A compound, wherein the compound has a structure selected from:

or a stereoisomer thereof; a pharmaceutically acceptable salt thereof, a pharmaceutically acceptable salt of the stereoisomer thereof.

60. A compound, wherein the compound has a structure selected from:

or a stereoisomer thereof; a pharmaceutically acceptable salt thereof, a pharmaceutically acceptable salt of the stereoisomer thereof.

61. The compound of embodiment 60 or the pharmaceutically acceptable salt thereof.

62. Another embodiment of the present invention comprises a pharmaceutical composition comprising the compound of any one of embodiments 1-61 or the pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier or diluent.

63. Another embodiment of the present invention comprises the method of treating cancer, the method comprising administering to a patient in need thereof a therapeutically effective amount of the compound of any of embodiments 1-62 or a pharmaceutically acceptable salt thereof.

64. The method of embodiment 63, wherein the cancer is a hematologic malignancy.

65. The method of embodiment 63, wherein the cancer is selected from the group consisting of breast cancer, colorectal cancer, skin cancer, melanoma, ovarian cancer, kidney cancer, lung cancer, non-small cell lung cancer, lymphoma, non-Hodgkin's lymphoma, myeloma, multiple myeloma, leukemia, and acute myelogenous leukemia.

66. The method of embodiment 65, wherein the cancer is multiple myeloma.

67. The method of embodiment 63, further comprising administering to the patient in need thereof a therapeutically effective amount of an additional pharmaceutically active compound.

68. The method of embodiment 67, wherein the additional pharmaceutically active compound is carfilzomib.

69. The method of embodiment 67, wherein the additional pharmaceutically active compound is venetoclax.

70. The method of embodiment 67, wherein the additional pharmaceutically active compound is cytarabine.

71. Another embodiment of the present invention comprises the use of a compound according to any one of embodiments 1-70 for treating cancer in a subject.

72. A compound according to any one of embodiments 1-71 in the preparation of a medicament for treating cancer.

73. The compound according to embodiment 72, wherein the cancer is a hematologic malignancy.

74. The compound according to embodiment 72, wherein the cancer is selected from the group consisting of breast cancer, colorectal cancer, skin cancer, melanoma, ovarian cancer, kidney cancer, lung cancer, non-small cell lung cancer, lymphoma, non-Hodgkin's lymphoma, myeloma, multiple myeloma, leukemia, and acute myelogenous leukemia.

75. The compound according to embodiment 74, wherein the cancer is multiple myeloma.

76. The compound according to embodiment 74, wherein the cancer is acute myelogenous leukemia.

77. The compound according to embodiment 74, wherein the cancer is non-Hodgkin's lymphoma.

Another embodiment of the present invention is directed to a method of inhibiting myeloid cell leukemia 1 protein (Mcl-1) of a cell comprising contacting the cell with the compound of Formula I in an effective amount to inhibit the Mcl-1, in conjunction with any of the above or below embodiments. In one embodiment, the contacting is in vitro. In another embodiment, the contacting is in vivo. In one embodiment, the contacting comprises administering the compound to a subject. In one embodiment, the administering is oral, parenteral, via injection, via inhalation, transdermal, or transmucosal. In one embodiment, the subject suffers from cancer.

One embodiment of the present invention is directed to a method of the treatment of cancer, comprising administering to a patient in need thereof a therapeutically effective amount of the compound of Formula I or a pharmaceutical composition comprising the compound of Formula I, or pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable excipient, in conjunction with any of the above or below embodiments. In one embodiment, the cancer is a hematologic malignancy. In one embodiment, the cancer is selected from the group consisting of breast cancer, colorectal cancer, skin cancer, melanoma, ovarian cancer, kidney cancer, lung cancer, non-small cell lung cancer, lymphoma, non-Hodgkin's lymphoma, myeloma, multiple myeloma, leukemia, and acute myelogenous leukemia. In one embodiment, the cancer is multiple myeloma. In another embodiment, the method further comprises the step of administering to the patient in need thereof a therapeutically effective amount of at least one additional pharmaceutically active compound. In one embodiment, the additional pharmaceutically active compound is carfilzomib, in conjunction with any of the above embodiments.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Methods and materials are described herein for use in the present disclosure; other, suitable methods and materials known in the art can also be used. The materials, methods, and examples are illustrative only and not intended to be limiting. All publications, patent applications, patents, sequences, database entries, and other references mentioned herein are incorporated by reference in their entirety. In case of conflict, the present specification, including definitions, will control.

Other features and advantages of the disclosure will be apparent from the following detailed description and FIGURES, and from the claims.

DETAILED DESCRIPTION

The symbol “-” represents a covalent bond and can also be used in a radical group to indicate the point of attachment to another group. In chemical structures, the symbol—is commonly used to represent a methyl group in a molecule.

As used herein, chemical structures which contain one or more stereocenters depicted with dashed and bold bonds (i.e.,

and

) are meant to indicate absolute stereochemistry of the stereocenter(s) present in the chemical structure. As used herein, bonds symbolized by a simple line do not indicate a stereo-preference. Unless otherwise indicated to the contrary, chemical structures that include one or more stereocenters which are illustrated herein without indicating absolute or relative stereochemistry encompass all possible stereoisomeric forms of the compound (e.g., diastereomers, enantiomers) and mixtures thereof. Structures with a single bold or dashed line, and at least one additional simple line, encompass a single enantiomeric series of all possible diastereomers.

As used herein, the term “about” is meant to account for variations due to experimental error. All measurements reported herein are understood to be modified by the term “about,” whether or not the term is explicitly used, unless explicitly stated otherwise. As used herein, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise.

The term “alkyl” means a straight or branched chain hydrocarbon. Representative examples of alkyl groups include methyl, ethyl, propyl, isopropyl, butyl, isobutyl, tert-butyl, sec-butyl, pentyl and hexyl. Typical alkyl groups are alkyl groups having from 1 to 8 carbon atoms, which groups are commonly represented as C₁₋₈ alkyl.

The term “compound” as used herein is meant to include all stereoisomers, geometric isomers, tautomers, and isotopes of the structures depicted. Compounds herein identified by name or structure as one particular tautomeric form are intended to include other tautomeric forms unless otherwise specified.

All compounds, and pharmaceutically acceptable salts thereof, can be found together with other substances such as water and solvents (e.g., hydrates and solvates).

The term “cycloalkyl” means a cyclic, nonaromatic hydrocarbon. Representative examples of cycloalkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl and cycloheptyl. A cycloalkyl group can contain one or more double bonds. Representative examples of cycloalkyl groups that contain double bonds include cyclopentenyl, cyclohexenyl, cyclohexadienyl and cyclobutadienyl. Common cycloalkyl groups are C₃₋₈ cycloalkyl groups.

The term “excipient”, as used herein, means any pharmaceutically acceptable additive, carrier, diluent, adjuvant or other ingredient, other than the active pharmaceutical ingredient (API), which is typically included for formulation and/or administration to a patient. Handbook of Pharmaceutical Excipients, 5^(th) Edition, R. C. Rowe, P. J. Sheskey, and S. C. Owen, editors, Pharmaceutical Press, 2005, Hardback, 928, 0853696187.

For the terms “for example” and “such as” and grammatical equivalences thereof, the phrase “and without limitation” is understood to follow unless explicitly stated otherwise.

The term “halogen” or “halo” means F, Cl, Br or I.

The term “patient” means subjects including animals, such as dogs, cats, cows, horses, sheep and humans. Particular patients are mammals. The term patient includes males and females.

The term “patient in need” means a patient having, or at risk of having, one or more diseases or conditions where the Mcl-1 protein is involved, such as cancers. Identifying a patient in need can be in the judgment of a subject or a health care professional and can be subjective (e.g., opinion) or objective (e.g., measurable by a test or diagnostic method).

The phrases “parenteral administration” and “administered parenterally” as used herein means modes of administration other than enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal and intrastemal injection, and infusion.

Compositions suitable for parenteral injection may comprise physiologically acceptable sterile aqueous or nonaqueous solutions, dispersions, suspensions, or emulsions, and sterile powders for reconstitution into sterile injectable solutions or dispersions. Examples of suitable aqueous and nonaqueous carriers, diluents, solvents, or vehicles include water, ethanol, polyols (propylene glycol, polyethylene glycol, glycerol, and the like), suitable mixtures thereof, vegetable oils (such as olive oil) and injectable organic esters such as ethyl oleate. Proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants.

The term “pharmaceutically acceptable” is employed herein to refer to those ligands, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for administration to a patient, commensurate with a reasonable benefit/risk ratio.

The phrase “pharmaceutically acceptable carrier” as used herein means a pharmaceutically acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, excipient, solvent or encapsulating material. As used herein the language “pharmaceutically acceptable carrier” includes buffer, sterile water for injection, solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents, and the like, compatible with pharmaceutical administration. Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient. Some examples of materials which can serve as pharmaceutically acceptable carriers include: (1) sugars, such as lactose, glucose, and sucrose; (2) starches, such as corn starch, potato starch, and substituted or unsubstituted β-cyclodextrin; (3) cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose, and cellulose acetate; (4) powdered tragacanth; (5) malt; (6) gelatin; (7) talc; (8) excipients, such as cocoa butter and suppository waxes; (9) oils, such as peanut oil, cottonseed oil, safflower oil, sesame oil, olive oil, corn oil, and soybean oil; (10) glycols, such as propylene glycol; (11) polyols, such as glycerin, sorbitol, mannitol, and polyethylene glycol; (12) esters, such as ethyl oleate and ethyl laurate; (13) agar; (14) buffering agents, such as magnesium hydroxide and aluminum hydroxide; (15) alginic acid; (16) pyrogen-free water; (17) isotonic saline; (18) Ringer's solution; (19) ethyl alcohol; (20) phosphate buffer solutions; and (21) other non-toxic compatible substances employed in pharmaceutical formulations. In certain embodiments, pharmaceutical compositions provided herein are non-pyrogenic, i.e., do not induce significant temperature elevations when administered to a patient.

The term “pharmaceutically acceptable salt” refers to the relatively non-toxic, inorganic and organic acid addition salts of a compound provided herein. These salts can be prepared in situ during the final isolation and purification of a compound provided herein, or by separately reacting the compound in its free base form with a suitable organic or inorganic acid, and isolating the salt thus formed. Representative salts include the hydrobromide, hydrochloride, sulfate, bisulfate, phosphate, nitrate, acetate, valerate, oleate, palmitate, stearate, laurate, benzoate, lactate, phosphate, tosylate, citrate, maleate, fumarate, succinate, tartrate, naphthylate, mesylate, glucoheptonate, lactobionate, laurylsulphonate salts, and amino acid salts, and the like. (See, for example, Berge et al. (1977) “Pharmaceutical Salts”, J. Pharm. Sci. 66: 1-19.)

The phrases “systemic administration”, “administered systemically”, “peripheral administration”, and “administered peripherally” as used herein mean the administration of a ligand, drug, or other material via route other than directly into the central nervous system, such that it enters the patient's system and thus, is subject to metabolism and other like processes, for example, subcutaneous administration.

The term “therapeutically effective amount” means an amount of a compound that ameliorates, attenuates or eliminates one or more symptom of a particular disease or condition, or prevents or delays the onset of one of more symptom of a particular disease or condition.

The terms “treating”, “treat” or “treatment” and the like include preventative (e.g., prophylactic) and palliative treatment.

The methods provided herein include the manufacture and use of pharmaceutical compositions, which include one or more of the compounds provided herein. Also included are the pharmaceutical compositions themselves.

In some embodiments, a compound provided herein may contain one or more acidic functional groups and, thus, is capable of forming pharmaceutically acceptable salts with pharmaceutically acceptable bases. The term “pharmaceutically acceptable salts” in these instances refers to the relatively non-toxic inorganic and organic base addition salts of a compound provided herein. These salts can likewise be prepared in situ during the final isolation and purification of the compound, or by separately reacting the purified compound in its free acid form with a suitable base, such as the hydroxide, carbonate, or bicarbonate of a pharmaceutically acceptable metal cation, with ammonia, or with a pharmaceutically acceptable organic primary, secondary, or tertiary amine. Representative alkali or alkaline earth salts include the lithium, sodium, potassium, calcium, magnesium, and aluminum salts, and the like. Representative organic amines useful for the formation of base addition salts include ethylamine, diethylamine, ethylenediamine, ethanolamine, diethanolamine, piperazine, and the like (see, for example, Berge et al., supra).

Wetting agents, emulsifiers, and lubricants, such as sodium lauryl sulfate and magnesium stearate, as well as coloring agents, release agents, coating agents, sweetening, flavoring, and perfuming agents, preservatives and antioxida

Examples of pharmaceutically acceptable antioxidants include: (1) water soluble antioxidants, such as ascorbic acid, cysteine hydrochloride, sodium bisulfate, sodium metabisulfite, sodium sulfite, and the like; (2) oil-soluble antioxidants, such as ascorbyl palmitate, butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), lecithin, propyl gallate, alpha-tocopherol, and the like; and (3) metal chelating agents, such as citric acid, ethylenediamine tetraacetic acid (EDTA), sorbitol, tartaric acid, phosphoric acid, and the like.

A pharmaceutical composition may also contain adjuvants such as preservatives, wetting agents, emulsifying agents, and dispersing agents. Prevention of the action of microorganisms may be ensured by the inclusion of various antibacterial and antifungal agents, for example, paraben, chlorobutanol, phenol sorbic acid, and the like. It may also be desirable to include tonicity-adjusting agents, such as sugars and the like into the compositions. In addition, prolonged absorption of the injectable pharmaceutical form may be brought about by the inclusion of agents which delay absorption such as aluminum monostearate and gelatin.

In some cases, in order to prolong the effect of one or more compounds provided herein, it is desirable to slow the absorption of the compound from subcutaneous or intramuscular injection. For example, delayed absorption of a parenterally administered compound can be accomplished by dissolving or suspending the compound in an oil vehicle.

The compounds of the present invention are administered to a patient in a therapeutically effective amount. The compounds can be administered alone or as part of a pharmaceutically acceptable composition or formulation. In addition, the compounds or compositions can be administered all at once, as for example, by a bolus injection, multiple times, such as by a series of tablets, or delivered substantially uniformly over a period of time, as for example, using transdermal delivery. The dose of the compound or composition can be varied over time. All combinations, delivery methods and administration sequences are contemplated.

The compounds of the present invention and in some embodiments, other additional pharmaceutically active compounds, can be administered to a patient either orally, rectally, parenterally, (for example, intravenously, intramuscularly, or subcutaneously) intracisternally, intravaginally, intraperitoneally, intravesically, locally (for example, powders, ointments or drops), or as a buccal or nasal spray. All methods that are used by those skilled in the art to administer a pharmaceutically active agent are contemplated.

Compositions prepared as described herein can be administered in various forms, depending on the disorder to be treated and the age, condition, and body weight of the patient, as is well known in the art. For example, where the compositions are to be administered orally, they may be formulated as tablets, capsules, granules, powders, or syrups; or for parenteral administration, they may be formulated as injections (intravenous, intramuscular, or subcutaneous), drop infusion preparations, or suppositories. For application by the ophthalmic mucous membrane route, they may be formulated as eye drops or eye ointments. These formulations can be prepared by conventional means in conjunction with the methods described herein, and, if desired, the active ingredient may be mixed with any conventional additive or excipient, such as a binder, a disintegrating agent, a lubricant, a corrigent, a solubilizing agent, a suspension aid, an emulsifying agent, or a coating agent.

Formulations suitable for oral administration may be in the form of capsules (e.g., gelatin capsules), cachets, pills, tablets, lozenges (using a flavored basis, usually sucrose and acacia or tragacanth), powders, troches, granules, or as a solution or a suspension in an aqueous or non-aqueous liquid, or as an oil-in-water or water-in-oil liquid emulsion, or as an elixir or syrup, or as pastilles (using an inert matrix, such as gelatin and glycerin, or sucrose and acacia) and/or as mouthwashes, and the like, each containing a predetermined amount of a compound provided herein as an active ingredient. A composition may also be administered as a bolus, electuary, or paste. Oral compositions generally include an inert diluent or an edible carrier.

Pharmaceutically compatible binding agents, and/or adjuvant materials can be included as part of an oral composition. In solid dosage forms for oral administration (capsules, tablets, pills, dragees, powders, granules, and the like), the active ingredient can be mixed with one or more pharmaceutically acceptable carriers, such as sodium citrate or dicalcium phosphate, and/or any of the following: (1) fillers or extenders, such as starches, cyclodextrins, lactose, sucrose, saccharin, glucose, mannitol, and/or silicic acid; (2) binders, such as, for example, carboxymethylcellulose, microcrystalline cellulose, gum tragacanth, alginates, gelatin, polyvinyl pyrrolidone, sucrose, and/or acacia; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato, corn, or tapioca starch, alginic acid, Primogel, certain silicates, and sodium carbonate; (5) solution retarding agents, such as paraffin; (6) absorption accelerators, such as quaternary ammonium compounds; (7) wetting agents, such as, for example, acetyl alcohol and glycerol monostearate; (8) absorbents, such as kaolin and bentonite clay; (9) lubricants, such a talc, calcium stearate, magnesium stearate, Sterotes, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof; (10) a glidant, such as colloidal silicon dioxide; (11) coloring agents; and (12) a flavoring agent such as peppermint, methyl salicylate, or orange flavoring. In the case of capsules, tablets, and pills, the pharmaceutical compositions may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugars, as well as high molecular weight polyethylene glycols, and the like.

A tablet may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared using binder (for example, gelatin or hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (for example, sodium starch glycolate or cross-linked sodium carboxymethyl cellulose), surface-active or dispersing agent. Molded tablets may be made by molding in a suitable machine a mixture of a powdered compound moistened with an inert liquid diluent.

Tablets, and other solid dosage forms, such as dragees, capsules, pills, and granules, may optionally be scored or prepared with coatings and shells, such as enteric coatings and other coatings well known in the pharmaceutical-formulating art. They may also be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile, other polymer matrices, liposomes, microspheres, and/or nanoparticles. They may be sterilized by, for example, filtration through a bacteria-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved in sterile water, or some other sterile injectable medium immediately before use. These compositions may also optionally contain opacifying agents and may be of a composition that they release the active ingredient(s) only, or preferentially, in a certain portion of the gastrointestinal tract, optionally, in a delayed manner. Examples of embedding compositions which can be used include polymeric substances and waxes. The active ingredient can also be in micro-encapsulated form, if appropriate, with one or more of the above-described excipients.

Liquid dosage forms for oral administration include pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups, and elixirs. In addition to the active ingredient, the liquid dosage forms may contain inert diluents commonly used in the art, such as, for example, water or other solvents, solubilizing agents, and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols, and fatty acid esters of sorbitan, and mixtures thereof.

Besides inert diluents, the oral compositions can also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, coloring, perfuming, and preservative agents.

Suspensions, in addition to the active compound(s) may contain suspending agents as, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar and tragacanth, and mixtures thereof.

Pharmaceutical compositions suitable for parenteral administration can include one or more compounds provided herein in combination with one or more pharmaceutically acceptable sterile aqueous or nonaqueous solutions, dispersions, suspensions or emulsions, or sterile powders which may be reconstituted into sterile injectable solutions or dispersions just prior to use, which may contain antioxidants, buffers, bacteriostats, solutes which render the formulation isotonic with the blood of the intended recipient or suspending or thickening agents.

In one embodiment, the IV formulation consists of a composition containing hydroxypropyl beta cyclodextrin within a pH range between 8-10 as a buffered or unbuffered solution. The IV formulation can be formulated as a sterile solution ready for injection, a sterile solution ready for dilution into an IV admixture or a sterile solid for reconstituion. The API in the IV formulation may exist as a free acid/base or an in situ salt.

Examples of suitable aqueous and nonaqueous carriers which may be employed in the pharmaceutical compositions provided herein include water for injection (e.g., sterile water for injection), bacteriostatic water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol such as liquid polyethylene glycol, and the like), sterile buffer (such as citrate buffer), and suitable mixtures thereof, vegetable oils, such as olive oil, injectable organic esters, such as ethyl oleate, and Cremophor EL™ (BASF, Parsippany, N.J.). In all cases, the composition must be sterile and should be fluid to the extent that easy syringability exists. Proper fluidity can be maintained, for example, by the use of coating materials, such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants.

The composition should be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi. Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars, polyalcohols such as mannitol, sorbitol, and sodium chloride in the composition. Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent that delays absorption, for example, aluminum monostearate and gelatin.

Sterile injectable solutions can be prepared by incorporating the active compound in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the active compound into a sterile vehicle, which contains a basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, the methods of preparation are freeze-drying (lyophilization), which yields a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.

Injectable depot forms can be made by forming microencapsule or nanoencapsule matrices of a compound provided herein in biodegradable polymers such as polylactide-polyglycolide. Depending on the ratio of drug to polymer, and the nature of the particular polymer employed, the rate of drug release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly(anhydrides). Depot injectable formulations are also prepared by entrapping the drug in liposomes, microemulsions or nanoemulsions, which are compatible with body tissue.

For administration by inhalation, the compounds can be delivered in the form of an aerosol spray from a pressured container or dispenser that contains a suitable propellant (e.g., a gas such as carbon dioxide) or a nebulizer. Such methods include those described in U.S. Pat. No. 6,468,798. Additionally, intranasal delivery can be accomplished, as described in, inter alia, Hamajima et al., Clin. Immunol. Immunopathol., 88(2), 205-10 (1998). Liposomes (e.g., as described in U.S. Pat. No. 6,472,375, which is incorporated herein by reference in its entirety), microencapsulation and nanoencapsulation can also be used. Biodegradable targetable microparticle delivery systems or biodegradable targetable nanoparticle delivery systems can also be used (e.g., as described in U.S. Pat. No. 6,471,996, which is incorporated herein by reference in its entirety).

Systemic administration of a therapeutic compound as described herein can also be by transmucosal or transdermal means. Dosage forms for the topical or transdermal administration of a compound provided herein include powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches, and inhalants. The active component may be mixed under sterile conditions with a pharmaceutically acceptable carrier, and with any preservatives, buffers, or propellants which may be required. For transmucosal or transdermal administration, penetrants appropriate to the barrier to be permeated are used in the formulation. Such penetrants are generally known in the art, and include, for example, for transmucosal administration, detergents, bile salts, and fusidic acid derivatives. Transmucosal administration can be accomplished through the use of nasal sprays or suppositories. For transdermal administration, the active compounds are formulated into ointments, salves, gels, or creams as generally known in the art.

The ointments, pastes, creams, and gels may contain, in addition to one or more compounds provided herein, excipients, such as animal and vegetable fats, oils, waxes, paraffins, starch, tragacanth, cellulose derivatives, polyethylene glycols, silicones, bentonites, silicic acid, talc, and zinc oxide, or mixtures thereof.

Powders and sprays can contain, in addition to a compound provided herein, excipients such as lactose, talc, silicic acid, aluminum hydroxide, calcium silicates, and polyamide powder, or mixtures of these substances. Sprays can additionally contain customary propellants, such as chlorofluorohydrocarbons and volatile unsubstituted hydrocarbons, such as butane and propane.

A compound provided herein can be administered by aerosol. This is accomplished by preparing an aqueous aerosol, liposomal preparation, or solid particles containing a compound or composition provided herein. A nonaqueous (e.g., fluorocarbon propellant) suspension could be used. In some embodiments, sonic nebulizers are used because they minimize exposing the agent to shear, which can result in degradation of the compound.

Ordinarily, an aqueous aerosol can be made by formulating an aqueous solution or suspension of the agent together with conventional pharmaceutically acceptable carriers and stabilizers. The carriers and stabilizers vary with the requirements of the particular composition, but typically include nonionic surfactants (TWEEN® (polysorbates), PLURONIC® (poloxamers), sorbitan esters, lecithin, CREMOPHOR® (polyethoxylates)), pharmaceutically acceptable co-solvents such as polyethylene glycol, innocuous proteins like serum albumin, sorbitan esters, oleic acid, lecithin, amino acids such as glycine, buffers, salts, sugars, or sugar alcohols. Aerosols generally are prepared from isotonic solutions.

Transdermal patches have the added advantage of providing controlled delivery of a compound provided herein to the body. Such dosage forms can be made by dissolving or dispersing the agent in the proper medium. Absorption enhancers can also be used to increase the flux of the compound across the skin. The rate of such flux can be controlled by either providing a rate controlling membrane or dispersing the compound in a polymer matrix or gel.

The pharmaceutical compositions can also be prepared in the form of suppositories or retention enemas for rectal and/or vaginal delivery. Formulations presented as a suppository can be prepared by mixing one or more compounds provided herein with one or more suitable nonirritating excipients or carriers comprising, for example, cocoa butter, glycerides, polyethylene glycol, a suppository wax or a salicylate, which is solid at room temperature, but liquid at body temperature and, therefore, will melt in the rectum or vaginal cavity and release the active agent. Formulations which are suitable for vaginal administration also include pessaries, tampons, creams, gels, pastes, foams, or spray formulations containing such carriers as are known in the art to be appropriate.

In one embodiment, the therapeutic compounds are prepared with carriers that will protect the therapeutic compounds against rapid elimination from the body, such as a controlled release formulation, including implants and microencapsulated delivery systems. Biodegradable, biocompatible polymers can be used, such as ethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen, polyorthoesters, and polylactic acid. Such formulations can be prepared using standard techniques, or obtained commercially (e.g., from Alza Corporation and Nova Pharmaceuticals, Inc). Liposomal suspensions (including liposomes targeted to selected cells with monoclonal antibodies to cellular antigens) can also be used as pharmaceutically acceptable carriers. These can be prepared according to methods known to those skilled in the art, for example, as described in U.S. Pat. No. 4,522,811, which is incorporated herein by reference in its entirety for all purposes.

The compounds of the present invention are used in the treatment of diseases, disorders or symptoms mediated by Mcl-1 inhibition. Examples of diseases, disorders or symptoms mediated by Mcl-1 inhibition include, but are not limited to, cancers. Non-limiting examples of cancers include breast cancer, colorectal cancer, skin cancer, melanoma, ovarian cancer, kidney cancer, lung cancer, non-small cell lung cancer, lymphoma, non-Hodgkin's lymphoma, myeloma, multiple myeloma, leukemia, and acute myelogenous leukemia.

The cancers can include carcinomas (originating in the outer layer of cells of the skin and internal membranes, e.g., breasts, kidneys, lungs, skin); sarcomas (arising from connective tissue such as bone, muscle, cartilage, and blood vessels), and hematologic malignancies (e.g., lymphomas and leukemias, which arise in the blood or blood-forming organs such as the spleen, lymph nodes, and bone marrow). Cancer cells can include, for example, tumor cells, neoplastic cells, malignant cells, metastatic cells, and hyperplastic cells.

In an embodiment, the disease, disorder or symptom is a hyperproliferative disorder, e.g., a lymphoma, leukemia, carcinoma (e.g., renal, breast, lung, skin), multiple myeloma, or a sarcoma. In one embodiment, the leukemia is acute myeloid leukemia. In one embodiment, the hyperproliferative disorder is a relapsed or refractory cancer.

Actual dosage levels of the active ingredients in the pharmaceutical compositions provided herein may be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic to the patient.

The specific dosage and dosage range depends on a number of factors, including the requirements of the patient, the severity of the condition or disease being treated, the pharmacokinetic characteristics of the compound(s) employed, and the route of administration. In some embodiments, the compositions provided herein can be provided in an aqueous solution containing about 0.1-10% w/v of a compound disclosed herein, among other substances, for parenteral administration. Typical dose ranges can include from about 0.01 to about 50 mg/kg of body weight per day, given in 1-4 divided doses. Each divided dose may contain the same or different compounds. The dosage will be a therapeutically effective amount depending on several factors including the overall health of a patient, and the formulation and route of administration of the selected compound(s).

Dosage forms or compositions containing a compound as described herein in the range of 0.005% to 100% with the balance made up from non-toxic carrier may be prepared. Methods for preparation of these compositions are known to those skilled in the art. The contemplated compositions may contain about 0.001%-100% active ingredient, in one embodiment from about 0.1 to about 95%, in another embodiment from about 75 to about 85%. Although the dosage will vary depending on the symptoms, age and body weight of the patient, the nature and severity of the disorder to be treated or prevented, the route of administration and the form of the drug, in general, a daily dosage of from about 0.01 to about 3,000 mg of the compound is recommended for an adult human patient, and this may be administered in a single dose or in divided doses. The amount of active ingredient which can be combined with a carrier material to produce a single dosage form will generally be that amount of the compound which produces a therapeutic effect.

The pharmaceutical composition may be administered at once, or may be divided into a number of smaller doses to be administered at intervals of time. It is understood that the precise dosage and duration of treatment is a function of the disease being treated and may be determined empirically using known testing protocols or by extrapolation from in vivo or in vitro test data. It is to be noted that concentrations and dosage values may also vary with the severity of the condition to be alleviated. It is to be further understood that for any particular patient, specific dosage regimens should be adjusted over time according to the individual need and the professional judgment of the person administering or supervising the administration of the compositions, and that the concentration ranges set forth herein are exemplary only and are not intended to limit the scope or practice of the claimed compositions.

The precise time of administration and/or amount of the composition that will yield the most effective results in terms of efficacy of treatment in a given patient will depend upon the activity, pharmacokinetics, and bioavailability of a particular compound, physiological condition of the patient (including age, sex, disease type and stage, general physical condition, responsiveness to a given dosage, and type of medication), route of administration, etc. However, the above guidelines can be used as the basis for fine-tuning the treatment, e.g., determining the optimum time and/or amount of administration, which will require no more than routine experimentation consisting of monitoring the patient and adjusting the dosage and/or timing

The compounds of the present invention can be administered alone, in combination with other compounds of the present invention, or with other pharmaceutically active compounds or agents. The other pharmaceutically active compounds/agents can be intended to treat the same disease or condition as the compounds of the present invention or a different disease or condition. If the patient is to receive or is receiving multiple pharmaceutically active compounds or agents, the compounds can be administered simultaneously, or sequentially.

The compounds of the present invention, or pharmaceutically acceptable salts thereof, may be used in combination with one or more additional pharmaceutically active compounds/agents.

One or more additional pharmaceutically active compounds or agents may be administered separately, as part of a multiple dose regimen, from the compound of Formula I (e.g., sequentially, e.g., on different overlapping schedules with the administration of one or more compounds of Formula I (including any subgenera or specific compounds thereof). In other embodiments, the one or more additional compounds/agents may be part of a single dosage form, mixed together with the compound of Formula I in a single composition. In still another embodiment, the one or more additional compounds/agents can be given as a separate dose that is administered at about the same time that one or more compounds of Formula I are administered (e.g., simultaneously with the administration of one or more compounds of Formula I (including any subgenera or specific compounds thereof). Both the compound of Formula I and the one or more additional compounds/agents can be present at dosage levels of between about 1 to 100%, and more preferably between about 5 to 95% of the dosage normally administered in a monotherapy regimen.

In a particular embodiment, the additional pharmaceutically active compound/agent is a compound or agent that can be used to treat a cancer. For example, the additional pharmaceutically active compound/agent can be selected from antineoplastic agents, anti-angiogenic agents, chemotherapeutic agents, and peptidal cancer therapy agents. In another embodiment, the antineoplastic agents are selected from antibiotic-type agents, alkylating agents, antimetabolite agents, hormonal agents, immunological agents, interferon-type agents, kinase inhibitors, proteasome inhibitors, and combinations thereof. It is noted that the additional pharmaceutically active compound/agent may be a traditional small organic chemical molecule or can be a macromolecule such as a protein, antibody, peptibody, DNA, RNA or a fragment of such macromolecules.

Examples of additional pharmaceutically active compounds/agents that can be used in the treatment of cancers and that can be used in combination with one or more compounds of the present invention include: acemannan; aclarubicin; aldesleukin; alitretinoin; amifostine; amrubicin; amsacrine; anagrelide; arglabin; arsenic trioxide; BAM 002 (Novelos); bicalutamide; broxuridine; celmoleukin; cetrorelix; cladribine; clotrimazole; cytarabine; DA 3030 (Dong-A); daclizumab; denileukin diftitox; deslorelin; dilazep; docosanol; doxercalciferol; doxifluridine; bromocriptine; cytarabine; HIT diclofenac; interferon alfa; tretinoin; edelfosine; edrecolomab; eflomithine; emitefur; epirubicin; epoetin beta; etoposide phosphate; exisulind; fadrozole; finasteride; fludarabine phosphate; formestane; fotemustine; gallium nitrate; gemtuzumab zogamicin; gimeracil/oteracil/tegafur combination; glycopine; goserelin; heptaplatin; human chorionic gonadotropin; human fetal alpha fetoprotein; ibandronic acid; interferon alfa; interferon alfa natural; interferon alfa-2; interferon alfa-2a; interferon alfa-2b; interferon alfa-N1; interferon alfa-n3; interferon alfacon-1; interferon alpha natural; interferon beta; interferon beta-1a; interferon beta-1b; interferon gamma natural; interferon gamma-1a; interferon gamma-1b; interleukin-1 beta; iobenguane; irsogladine; lanreotide; LC 9018 (Yakult); leflunomide; lenograstim; lentinan sulfate; letrozole; leukocyte alpha interferon; leuprorelin; levamisole+fluorouracil; liarozole; lobaplatin; lonidamine; lovastatin; masoprocol; melarsoprol; metoclopramide; mifepristone; miltefosine; mirimostim; mismatched double stranded RNA; mitoguazone; mitolactol; mitoxantrone; molgramostim; nafarelin; naloxone+pentazocine; nartograstim; nedaplatin; nilutamide; noscapine; novel erythropoiesis stimulating protein; NSC 631570 octreotide; oprelvekin; osaterone; paclitaxel; pamidronic acid; peginterferon alfa-2b; 73rimethyl polysulfate sodium; pentostatin; picibanil; pirarubicin; rabbit antithymocyte polyclonal antibody; polyethylene glycol interferon alfa-2a; porfimer sodium; raltitrexed; rasburicase; rhenium Re 186 etidronate; RII retinamide; romurtide; samarium (153 Sm) lexidronam; sargramostim; sizofuran; sobuzoxane; sonermin; strontium-89 chloride; suramin; tasonermin; tazarotene; tegafur; temoporfin; teniposide; tetrachlorodecaoxide; thymalfasin; thyrotropin alfa; toremifene; tositumomab-iodine 131; treosulfan; tretinoin; trilostane; trimetrexate; triptorelin; trametinib; tumor necrosis factor alpha natural; ubenimex; bladder cancer vaccine; Maruyama vaccine; melanoma lysate vaccine; valrubicin; venetoclax; verteporfin; virulizin; zinostatin stimalamer; abarelix; AE 941 (Aetema); ambamustine; antisense oligonucleotide; bcl-2 (Genta); APC 8015 (Dendreon); dexaminoglutethimide; diaziquone; EL 532 (Elan); EM 800 (Endorecherche); eniluracil; etanidazole; fenretinide; galocitabine; gastrin 17 immunogen; HLA-B7 gene therapy (Vical); granulocyte macrophage colony stimulating factor; histamine dihydrochloride; ibritumomab tiuxetan; ilomastat; IM 862 (Cytran); interleukin-2; iproxifene; LDI 200 (Milkhaus); leridistim; lintuzumab; CA 125 monoclonal antibody (Mab) (Biomira); cancer Mab (Japan Pharmaceutical Development); HER-2 and Fc Mab (Medarex); idiotypic 105AD7 Mab (CRC Technology); idiotypic CEA Mab (Trilex); LYM-1-iodine 131 Mab (Techniclone); polymorphic epithelial mucin-yttrium 90 Mab (Antisoma); marimastat; menogaril; mitumomab; motexafin gadolinium; MX 6 (Galderma); nolatrexed; P 30 protein; pegvisomant; porfiromycin; prinomastat; RL 0903 (Shire); rubitecan; satraplatin; sodium phenylacetate; sparfosic acid; SRL 172 (SR Pharma); SU 5416 (SUGEN); TA 077 (Tanabe); tetrathiomolybdate; thaliblastine; thrombopoietin; tin ethyl etiopurpurin; tirapazamine; cancer vaccine (Biomira); melanoma vaccine; melanoma oncolysate vaccine; viral melanoma cell lysates vaccine; valspodarl; fluorouracil; 5-fluorouracil; 74rimethyla; imatinib; altretamine; cladibrine; cyclophosphamine; decarazine; irinotecan; mitosmycin; mitoxane; topotecan; vinorelbine; 74rimethyla; mithram; imiquimod; alemtuzmab; exemestane; bevacizumab; cetuximab; azacitidine; clofarabine; decitabine; desatinib; dexrazoxane; docetaxel; epirubicin; oxaliplatin; erlotinib; raloxifene; fulvestrant; letrozole; gefitinib; gemtuzumab; trastuzumab; gefitinib; ixabepilone; lapatinib; lenalidomide; aminolevulinic acid; temozolomide; nelarabine; sorafenib; nilotinib; pegaspargase; pemetrexed; rituximab; dasatinib; thalidomide; bexarotene; temsirolimus; bortezomib (Velcade®, Millenium Pharmaceuticals, Inc.); 75rimethylam; oprozomib; vorinostat; capecitabine; zoledronic acid; anastrozole; sunitinib; aprepitant and nelarabine, or a pharmaceutically acceptable salt thereof.

Additional pharmaceutically active compounds/agents that can be used in the treatment of cancers and that can be used in combination with one or more compound of the present invention include: epoetin alfa; darbepoetin alfa; panitumumab; pegfilgrastim; palifermin; filgrastim; denosumab; ancestim; AMG 102; AMG 386; AMG 479; AMG 655; AMG 745; AMG 951; and AMG 706, or a pharmaceutically acceptable salt thereof.

In certain embodiments, a composition provided herein is conjointly administered with a chemotherapeutic agent. Suitable chemotherapeutic agents may include, natural products such as vinca alkaloids (e.g., vinblastine, vincristine, and vinorelbine), paclitaxel, epidipodophyllotoxins (e.g., etoposide and teniposide), antibiotics (e.g., dactinomycin (actinomycin D), daunorubicin, doxorubicin, and idarubicin), anthracyclines, mitoxantrone, bleomycins, plicamycin (mithramycin), mitomycin, enzymes (e.g., L-asparaginase which systemically metabolizes L-asparagine and deprives cells which do not have the capacity to synthesize their own asparagine), antiplatelet agents, antiproliferative/antimitotic alkylating agents such as nitrogen mustards (e.g., mechlorethamine, cyclophosphamide and analogs, melphalan, and chlorambucil), ethylenimines and methylmelamines (e.g., hexaamethylmelaamine and thiotepa), CDK inhibitors (e.g., seliciclib, UCN-01, P1446A-05, PD-0332991, dinaciclib, P27-00, AT-7519, RGB286638, and SCH727965), alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine (BCNU) and analogs, and streptozocin), trazenes-dacarbazinine (DTIC), antiproliferative/antimitotic antimetabolites such as folic acid analogs (e.g., methotrexate), pyrimidine analogs (e.g., fluorouracil, floxuridine, and cytarabine), purine analogs and related inhibitors (e.g., mercaptopurine, thioguanine, pentostatin and 2-chlorodeoxyadenosine), aromatase inhibitors (e.g., anastrozole, exemestane, and letrozole), and platinum coordination complexes (e.g., cisplatin and carboplatin), procarbazine, hydroxyurea, mitotane, aminoglutethimide, histone deacetylase (HDAC) inhibitors (e.g., trichostatin, sodium butyrate, apicidan, suberoyl anilide hydroamic acid, vorinostat, LBH 589, romidepsin, ACY-1215, and panobinostat), mTor inhibitors (e.g., temsirolimus, everolimus, ridaforolimus, and sirolimus), KSP(Eg5) inhibitors (e.g., Array 520), DNA binding agents (e.g., Zalypsis), PI3K delta inhibitor (e.g., GS-1101 and TGR-1202), PI3K delta and gamma inhibitor (e.g., CAL-130), multi-kinase inhibitor (e.g., TG02 and sorafenib), hormones (e.g., estrogen) and hormone agonists such as leutinizing hormone releasing hormone (LHRH) agonists (e.g., goserelin, leuprolide and triptorelin), BAFF-neutralizing antibody (e.g., LY2127399), IKK inhibitors, p38MAPK inhibitors, anti-IL-6 (e.g., CNT0328), telomerase inhibitors (e.g., GRN 163L), aurora kinase inhibitors (e.g., MLN8237), cell surface monoclonal antibodies (e.g., anti-CD38 (HUMAX-CD38), anti-CS1 (e.g., elotuzumab), inhibitors of KRAS including covalent inhibiors of KRAS G12C, MEK inhibitor, including trametinib, HSP90 inhibitors (e.g., 17 AAG and KOS 953), P13K/Akt inhibitors (e.g., perifosine), Akt inhibitor (e.g., GSK-2141795), PKC inhibitors (e.g., enzastaurin), FTIs (e.g., Zarnestra™), anti-CD138 (e.g., BT062), Torcl/2 specific kinase inhibitor (e.g., INK128), kinase inhibitor (e.g., GS-1101), ER/UPR targeting agent (e.g., MKC-3946), cFMS inhibitor (e.g., ARRY-382), JAK1/2 inhibitor (e.g., CYT387), PARP inhibitor (e.g., olaparib and veliparib (ABT-888)), BCL-2 antagonist. Other chemotherapeutic agents may include mechlorethamine, camptothecin, ifosfamide, tamoxifen, raloxifene, gemcitabine, navelbine, sorafenib, or any analog or derivative variant of the foregoing.

The compounds of the present invention may also be used in combination with radiation therapy, hormone therapy, surgery and immunotherapy, which therapies are well known to those skilled in the art.

In certain embodiments, a pharmaceutical composition provided herein is conjointly administered with a steroid. Suitable steroids may include, but are not limited to, 21-acetoxypregnenolone, alclometasone, algestone, amcinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, clobetasol, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difuprednate, enoxolone, fluazacort, flucloronide, flumethasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol propionate, halometasone, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methylprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylaminoacetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortol, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, and salts and/or derivatives thereof. In a particular embodiment, the compounds of the present invention can also be used in combination with additional pharmaceutically active agents that treat nausea. Examples of agents that can be used to treat nausea include: dronabinol; granisetron; metoclopramide; ondansetron; and prochlorperazine; or a pharmaceutically acceptable salt thereof.

As one aspect of the present invention contemplates the treatment of the disease/conditions with a combination of pharmaceutically active compounds that may be administered separately, the invention further relates to combining separate pharmaceutical compositions in kit form. The kit comprises two separate pharmaceutical compositions: a compound of the present invention, and a second pharmaceutical compound. The kit comprises a container for containing the separate compositions such as a divided bottle or a divided foil packet. Additional examples of containers include syringes, boxes, and bags. In some embodiments, the kit comprises directions for the use of the separate components. The kit form is particularly advantageous when the separate components are preferably administered in different dosage forms (e.g., oral and parenteral), are administered at different dosage intervals, or when titration of the individual components of the combination is desired by the prescribing health care professional.

The compounds of the present invention can be administered as pharmaceutically acceptable salts, esters, amides or prodrugs. The term “salts” refers to inorganic and organic salts of compounds of the present invention. The salts can be prepared in situ during the final isolation and purification of a compound, or by separately reacting a purified compound in its free base or acid form with a suitable organic or inorganic base or acid and isolating the salt thus formed. Representative salts include the hydrobromide, hydrochloride, sulfate, bisulfate, nitrate, acetate, oxalate, palmitiate, stearate, laurate, borate, benzoate, lactate, phosphate, tosylate, citrate, maleate, fumarate, succinate, tartrate, naphthylate, mesylate, glucoheptonate, lactobionate, and laurylsulphonate salts, and the like. The salts may include cations based on the alkali and alkaline earth metals, such as sodium, lithium, potassium, calcium, magnesium, and the like, as well as non-toxic ammonium, quaternary ammonium, and amine cations including, but not limited to, ammonium, tetramethylammonium, tetraethylammonium, methylamine, dimethylamine, trimethylamine, 78rimethylamine, ethylamine, and the like. See, for example, S. M. Berge, et al., “Pharmaceutical Salts,” J Pharm Sci, 66: 1-19 (1977).

The term “prodrug” means compounds that are transformed in vivo to yield a compound of the present invention. The transformation may occur by various mechanisms, such as through hydrolysis in blood. A discussion of the use of prodrugs is provided by T. Higuchi and W. Stella, “Pro-drugs as Novel Delivery Systems,” Vol. 14 of the A.C.S. Symposium Series, and in Bioreversible Carriers in Drug Design, ed. Edward B. Roche, American Pharmaceutical Association and Pergamon Press, 1987.

To illustrate, if the compound of the invention contains a carboxylic acid functional group, a prodrug can comprise an ester formed by the replacement of the hydrogen atom of the acid group with a group such as (C₁-C₈ alkyl, (C₂-C1₂)alkanoyloxymethyl, 1-(alkanoyloxy)ethyl having from 4 to 9 carbon atoms, 1-methyl-1-(alkanoyloxy)ethyl having from 5 to 10 carbon atoms, alkoxycarbonyloxymethyl having from 3 to 6 carbon atoms, 1-(alkoxycarbonyloxy)ethyl having from 4 to 7 carbon atoms, 1-methyl-1-(alkoxycarbonyloxy)ethyl having from 5 to 8 carbon atoms, N-(alkoxycarbonyl)aminomethyl having from 3 to 9 carbon atoms, 1-(N-(alkoxycarbonyl)aminomethyl having from 4 to 10 carbon atoms, 3-phthalidyl, 4-crotonolactonyl, gamma-butyrolacton-4-yl, di-N,N—(C₁-C₂)alkylamino(C₂-C₃)alkyl (such as β-dimethylaminoethyl), carbamoyl-(C₁-C₂)alkyl, N,N-di(C₁-C₂)alkylcarbamoyl-(C₁-C₂)alkyl and piperidino-, pyrrolidino- or morpholino(C₂₋₃)alkyl.

Similarly, if a compound of the present invention comprises an alcohol functional group, a prodrug can be formed by the replacement of the hydrogen atom of the alcohol group with a group such as (C₁-C₆)alkanoyloxymethyl, 1-((C₁-C₆)alkanoyloxy)ethyl, 1-methyl-1-((C₁-C₆)alkanoyloxy)ethyl, (C₁-C₆)alkoxycarbonyloxymethyl, N—(C₁-C₆)alkoxycarbonylaminomethyl, succinoyl, (C₁-C₆)alkanoyl, α-amino(C₁-C₄)alkanoyl, arylacyl and α-aminoacyl, or α-aminoacyl-α-aminoacyl, where each α-aminoacyl group is independently selected from the naturally occurring L-amino acids, —P(O)(OH)₂, —P(O)(O(C₁-C₆)alkyl)₂ or glycosyl (the radical resulting from the removal of a hydroxyl group of the hemiacetal form of a carbohydrate).

The compounds of the present invention may contain asymmetric or chiral centers, and therefore, exist in different stereoisomeric forms. It is contemplated that all stereoisomeric forms of the compounds as well as mixtures thereof, including racemic mixtures, form part of the present invention. In addition, the present invention contemplates all geometric and positional isomers. For example, if the compound contains a double bond, both the cis and trans forms (designated as Z and E, respectively), as well as mixtures, are contemplated.

Mixture of stereoisomers, such as diastereomeric mixtures, can be separated into their individual stereochemical components on the basis of their physical chemical differences by known methods such as chromatography and/or fractional crystallization. Enantiomers can also be separated by converting the enantiomeric mixture into a diasteromeric mixture by reaction with an appropriate optically active compound (e.g., an alcohol), separating the diastereomers and converting (e.g., hydrolyzing) the individual diastereomers to the corresponding pure enantiomers.

The compounds of the present invention may exist in unsolvated as well as solvated forms with pharmaceutically acceptable solvents such as water (hydrate), ethanol, and the like. The present invention contemplates and encompasses both the solvated and unsolvated forms.

It is also possible that compounds of the present invention may exist in different tautomeric forms. All tautomers of compounds of the present invention are contemplated. Those skilled in the art will recognize that the compound names and structures contained herein may be based on a particular tautomer of a compound. While the name or structure for only a particular tautomer may be used, it is intended that all tautomers are encompassed by the present invention, unless stated otherwise.

It is also intended that the present invention encompass compounds that are synthesized in vitro using laboratory techniques, such as those well known to synthetic chemists; or synthesized using in vivo techniques, such as through metabolism, fermentation, digestion, and the like. It is also contemplated that the compounds of the present invention may be synthesized using a combination of in vitro and in vivo techniques.

The compounds of the present invention may exist in various solid states including crystalline states and as an amorphous state. The different crystalline states, also called polymorphs, and the amorphous states of the present compounds are contemplated as part of this invention.

EXAMPLES

The examples presented below illustrate specific embodiments of the present invention. These examples are meant to be representative and are not intended to limit the scope of the claims in any manner.

The following abbreviations may be used herein:

-   ˜ about -   Ac acetate -   Ac₂O acetic anhydride -   AcOH or HOAc acetic acid -   Br broad tert-butyloxycarbonyl -   Boc -   Caled calculated -   CO₂ carbon dioxide -   CSA 10-camphorsulfonic acid -   d day or doublet -   DBU 1,8-diazabicyclo[5.4.0]undec-7-ene -   DCE Dichloroethane -   DCM Dichloromethane -   DEA Diethylamine -   Dess-Martin     1,1,1-triacetoxy-1,1-dihydro-1,2-benziodoxol-3-periodinane; (1H)-one -   DIEA or DIPEA Diisopropylethylamine -   DMA N,N-dimethylacetamide -   DMAP 4-dimethylaminopyridine -   DMF N,N-dimethylformamide -   DMSO dimethyl sulfoxide -   EDC N-ethyl-N′-(3-dimethylaminopropyl)carbodiimide -   ee or e.e. enantiomeric excess -   ELISA enzyme-linked immunosorbent assay -   eq Equivalent -   ESI or ES electrospray ionization -   Et Ethyl -   Et₂O diethyl ether -   EtOAc ethyl acetate -   Et₃N triethylamine -   EtOH ethyl alcohol -   g gram(s) -   GC gas chromatography -   h hour(s) -   ¹H NMR proton nuclear rnagnetic resonance spectroscopy -   H₂ hydrogen gas -   H₂O Water -   H₂SO₄ sulfuric acid 1-[Bis(dimethylamino)methylene]-TH-1,2,3-HATU     triazolo[4,5-b]pyridinium 3-oxid hexafluorophosphate -   HCl hydrochloric acid -   Hex hexane(s) -   HPLC high performance liquid chromatography -   Hz Hertz -   IP intraperitoneal -   IPA isopropyl alcohol -   IPAc isopropyl acetate -   K₂CO₃ potassium carbonate -   K₃PO₄ potassium phosphate -   KF Karl Fischer titration -   KHMDS potassium hexamethyldisilazide -   KOAc potassium acetate -   KOH potassium hydroxide -   KOtBu Potassium tert-butoxide -   L liter(s) -   LAH lithium aluminium hydride -   LCMS, LC-MS or -   LC/MS liquid chromatography mass spectrometry -   LiHMDS lithium hexamethyldisilazide -   LiOH lithium hydroxide -   m multiplet -   M molar (mol L−1) -   Me methyl -   MeCN acetonitrile -   MHz megahertz -   MeI iodomethane -   MeOH methyl alcohol -   MeTHF methyltetrahydrofuran -   mg milligram(s) -   MgSO₄ magnesium sulphate -   min minute(s) -   μm micrometer -   μL microliter -   mL milliliter(s) -   mm millimeter -   mol mole -   MS mass spectrometry -   MSA methanesulfonic acid -   MsCl methanesulfonyl chloride -   m/z mass-to-charge ratio -   N Normality (Eq/L) -   N₂ nitrogen gas -   NaCl sodium chloride -   Na₂CO₃ sodium carbonate -   NaHCO₃ sodium bicarbonate -   NaOH sodiumhydroxide -   NaOtBu sodium tert-butoxide -   Na₂SO₄ sodium sulfate -   Na₂S₂O₃ sodium thiosulfate -   NH₃ ammonia, azane -   NH₄Cl ammonium chloride -   NH₄OH ammonium hydroxide -   NMR nuclear magnetic resonance spectroscopy -   OMe methoxy -   PO per oral -   +ve positive -   Ph phenyl -   PhMe toluene -   PMB p-methoxybenzyl -   ppm parts per million -   prep preparative -   psi pounds per square inch -   q quartet -   QD once daily -   QNMR quantitative NMR -   RBF round-bottomed flask -   RT or rt or r.t. room temperature -   s singlet -   sat. or sat'd or satd Saturated -   SFC supercritical fluid chromatography -   SiO₂ silicon dioxide, silica -   T triplet -   tBu tert-butyl -   t-BuOH tert-butanol -   TFA triflouroacetic acid -   THF Tetrahydrofuran -   TLC thin layer chromatography -   TsOH toluene sulfonic acid -   UV Ultraviolet -   v/v Volume per volume -   wt % Weight percent

It is noted that when a percent (%) is used with regard to a liquid, it is a percent by volume with respect to the solution. When used with a solid, it is the percent with regard to the solid composition.

The following synthetic schemes show generally how to make intermediates and compounds of the present invention.

General Synthetic Schemes

Unless otherwise stated, starting materials and reagents used in preparing these compounds are either available from commercial suppliers such as Aldrich Chemical Co., (Milwaukee, Wis.) or are prepared by methods known to those skilled in the art following procedures set forth in references such as Fieser and Fieser's Reagents for Organic Synthesis, Volumes 1-17 (John Wiley and Sons, 1991); Rodd's Chemistry of Carbon Compounds, Volumes 1-5 and Supplementals (Elsevier Science Publishers, 1989); Organic Reactions, Volumes 1-40 (John Wiley and Sons, 1991), March's Advanced Organic Chemistry (John Wiley and Sons, 4th Edition) and Larock's Comprehensive Organic Transformations (VCH Publishers Inc., 1989).

The starting materials for the following synthetic methods can be found in the General Methods and General Synthesis for Intermediates. The synthesis of some of the starting materials and the intermediates are disclosed in U.S. Pat. No. 9,562,061 and PCT/US17/19336, respectively, herein incorporated by reference in their entireties for all purposes. These schemes are merely illustrative of some methods by which the compounds of this invention can be synthesized, and various modifications to these schemes can be made and will be suggested to one skilled in the art having referred to this disclosure. The starting materials and the intermediates, and the final products of the reaction may be isolated and purified if desired using conventional techniques, including but not limited to filtration, distillation, crystallization, chromatography and the like. Such materials may be characterized using conventional means, including physical constants and spectral data.

Unless specified to the contrary, the reactions described herein take place at atmospheric pressure over a temperature range from about −78° C. to about 150° C., more preferably from about 0° C. to about 125° C. and most preferably at about room (or ambient) temperature, e.g., about 22° C.

IUPAC names were generated using either ACD/Name v2015 or ChemBioDraw Ultra 12.

General Methods 1 and 2: Synthesis of 1,3-Dioxane/Dioxolane Derivatives

Examples 1, 2, 6 and 43 (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 1) and (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24-]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 2) and (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 6) and (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 43)

Step 1: 1S,3′R,6′R,7′Z,11′S,12′R)-6-Chloro-7′-(METHOXYMETHYLIDENE)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE and (1S,3′R,6′R,7′E,11′S,12′R)-6-CHLORO-7′-(METHOXYMETHYLIDENE)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE

To a stirred ice-cooled solution of (methoxymethyl)triphenylphosphonium chloride (2.288 g, 6.68 mmol) in THF (10 mL) was dropwise added potassium bis(trimethylsilyl)amide, 1M solution in tetrahydrofuran (6.68 mL, 6.68 mmol) over 10 min. The resulting mixture was stirred at 0° C. for a period of 35 min. A solution of (1S,3′R,6′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-3,4-dihydro-2H,7′H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′,15′-dione 13′,13′-dioxide (0.50 g, 0.834 mmol) in THF (6 mL) was slowly added at 0° C. via a syringe. The resulting mixture was stirred at 0° C. for 1 h, and allowed to slowly warm up to rt and stirred at rt for a period of 4 h. Upon workup, the reaction mixture was poured into ice and a saturated aqueous solution of ammonium chloride and extracted with EtOAc (2×). The combined organics were dried over anhydrous sodium sulfate and concentrated in vacuo. The residue was loaded onto a silica gel precolumn (25 g) and subjected to combi-flash column chromatography on a 40-g ISCO GOLD, eluting with EtOAc/Hexanes (35 min from 0 to 40%), to give a geoisomeric mixture of (1S,3′R,6′R,7′Z,11′S,12′R)-6-chloro-7′-(methoxymethylidene)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide and (1S,3′R,6′R,7′E,11′S,12′R)-6-chloro-7′-(methoxymethylidene)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.019,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (0.34 g, 0.542 mmol, 65.0% yield) as a colorless film. The geoisomeric ratio was determined to be 2 (the first eluting isomer on reverse-phase HPLC) to 3. This mixture was directly used in the next step without separation. MS (ESI, +ve) m/z 627.2 [M+H]⁺.

Step 2: (1S,3′R,6′R,7′s,11′s,12′R)-6-CHLORO-11′,12′-DIMETHYL-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIENE]-7′-CARBALDEHYDE 13′,13′-DIOXIDE and (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIENE]-7′-CARBALDEHYDE 13′,13′-DIOXIDE

To a stirred solution of a geoisomeric mixture of (1S,3′R,6′R,7′Z,11′S,12′R)-6-chloro-7′-(methoxymethylidene)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide and (1S,3′R,6′R,7′E,11′S,12′R)-6-chloro-7′-(methoxymethylidene)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (1.93 g, 3.08 mmol) in THF (50 mL) was added at rt hydrochloric acid 1 N standard aqueous solution (30 mL, 360 mmol) followed by commercial concentrated HCl (37% aq. commercial) (6.0 mL). The resulting mixture was stirred at rt for 66 h. Upon workup, the white precipitate was collected by vacuum filtration to give, in the first batch, an epimeric mixture of (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide and (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide (1.62 g, 2.64 mmol, 86% yield). The epimeric ratio was determined to be about 65 to 35 favoring the (s)-epimer. The filtrate was diluted with water and extracted with EtOAc (2×). The combined organics were dried over anhydrous sodium sulfate and concentrated in vacuo to give, in the second batch, 66 mg of a nearly 1-to-1 epimeric mixture of the same two compounds. MS (ESI, +ve) m/z 613.2 [M+H]+.

Step 3: (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 1) and (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 2) and (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 6) and (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 43)

A mixture of an epimeric mixture of (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide and (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide (1.20 g, 1.957 mmol), 2-(dimethylamino)propane-1,3-diol (4.00 g, 33.6 mmol, from J&W PharmLab, LLC), and 4-methylbenzene sulfonic acid, monohydrate (6.60 g, 34.7 mmol) in toluene (280 mL) in a 500-mL round-bottomed flask equipped with a Dean-Stark condenser was heated at reflux for 4 h. The LC-MS of both the gluey precipitate and the clear toluene solvent layer indicated a nearly quantitative conversion and the formation of four stereoisomeric products. The mixture was left at rt overnight and the initially gluey precipitate solidified the next day. The clear toluene layer was decanted and the remaining solid was broken into pieces with a spatula and poured into ice and 1 N sodium hydroxide aqueous solution and extracted with EtOAc (3×). The combined organics were dried over anhydrous sodium sulfate and concentrated in vacuo to give the crude product (2 g). This was dissolved in DCM and loaded onto a silica gel precolumn (25 g) and subjected to combi-flash column chromatography on a 24-g ISCO GOLD eluting with (MeOH/DCM (25 min from 6 to 15%) (repetitive) to give in total four isomeric products: (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (527 mg, 0.74 mmol, 38% yield) (EXAMPLE 1) was harvested as an off-white solid. It was the first major product and the first eluting isomer off of preparative reverse-phase HPLC. ¹H NMR (500 MHz, DICHLOROMETHANE-d₂) (collected from lyophilized material after preparative reverse-phase HPLC purification (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method))¹H NMR (500 MHz, DICHLOROMETHANE-d₂) δ 12.94 (br s, 1H), 8.29 (br s, 1H), 7.71 (d, J=8.44 Hz, 1H), 7.17 (dd, J=2.32, 8.56 Hz, 1H), 7.09 (d, J=2.20 Hz, 1H), 6.87-6.96 (m, 3H), 4.46-4.56 (m, 2H), 4.04-4.14 (m, 4H), 3.78 (d, J=15.16 Hz, 1H), 3.69 (d, J=14.18 Hz, 1H), 3.22 (d, J=14.31 Hz, 1H), 3.13 (br s, 1H), 3.00 (br d, J=2.20 Hz, 6H), 2.66-2.84 (m, 5H), 2.40-2.49 (m, 2H), 2.04 (br d, J=13.69 Hz, 1H), 1.88-1.98 (m, 3H), 1.68-1.86 (m, 3H), 1.56-1.64 (m, 2H), 1.46-1.54 (m, 2H), 1.35-1.43 (m, 5H), 1.23-1.32 (m, 2H), 1.12-1.20 (m, 1H), 0.98 (d, J=6.85 Hz, 3H). MS (ESI, +ve) m/z 714.2 [M+H]⁺; (1S,3′R,6′R,7′R,11′5,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (350 mg, 0.49 mmol, 25% yield) (EXAMPLE 2) as an off-white solid. It was the second major product and last eluting isomer off of preparative reverse-phase HPLC. ¹H NMR (500 MHz, DICHLOROMETHANE-d₂) (collected from lyophilized material after preparative reverse-phase HPLC purification (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method)) δ 8.32 (br s, 1H), 7.71 (d, J=8.56 Hz, 1H), 7.32 (d, J=1.47 Hz, 1H), 7.17 (dd, J=2.20, 8.44 Hz, 1H), 7.09 (d, J=2.20 Hz, 1H), 6.92-6.96 (m, 1H), 6.85-6.91 (m, 1H), 4.50-4.63 (m, 3H), 3.91-4.12 (m, 6H), 3.68 (d, J=14.31 Hz, 1H), 3.37-3.49 (m, 1H), 3.19 (d, J=14.18 Hz, 1H), 2.72-2.90 (m, 9H), 2.37-2.52 (m, 2H), 2.10 (br d, J=13.82 Hz, 2H), 1.88-1.97 (m, 2H), 1.78-1.86 (m, 1H), 1.67-1.75 (m, 1H), 1.49-1.65 (m, 6H), 1.30-1.41 (m, 5H), 1.20-1.29 (m, 2H), 0.99 (d, J=6.72 Hz, 3H). MS (ESI, +ve) m/z 714.2 [M+H]⁺;

an impure (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (EXAMPLE 6) as a minor isomeric product in a mixture with (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (Example 2). This mixture was separated by SFC (Thar 80 SFC with 250×21 mm OJ-H column with 11.5 mL/min methanol (+20 mM NH₃)+38.5 g/min CO₂, 23% co-solvent at 50 g/min. Temp.=28° C., Outlet pressure=100 bar, Wavelength=243 nm. Injected 0.3 mL of 42 mg sample dissolved in 5.0 mL of MeOH/DCM 4:1; c=8.4 mg/mL and 2.5 mg per injection. First peak collected by time window, second by mV Threshold. Cycle time 9 min, run time 17 min.) to give (1S,3′R,6′R,7′R,11′5,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (EXAMPLE 6) as an off-white solid. ¹H NMR (400 MHz, MeOH) (collected from its TFA salt after lyophilization) δ 7.73 (d, J=8.61 Hz, 1H), 7.38 (d, J=1.76 Hz, 1H), 7.17 (dd, J=2.15, 8.61 Hz, 1H), 7.10 (d, J=2.15 Hz, 1H), 7.04 (dd, J=1.86, 8.12 Hz, 1H), 6.91 (d, J=8.02 Hz, 1H), 4.54-4.68 (m, 3H), 3.86-4.11 (m, 6H), 3.59-3.68 (m, 2H), 3.22 (d, J=14.08 Hz, 1H), 2.68-2.99 (m, 8H), 2.36-2.61 (m, 2H), 2.04-2.16 (m, 2H), 1.81-1.98 (m, 3H), 1.49-1.74 (m, 7H), 1.32-1.46 (m, 5H), 1.21-1.31 (m, 2H), 1.03 (d, J=6.65 Hz, 3H). MS (ESI, +ve) m/z 714.2 [M+H]⁺; and an impure (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (EXAMPLE 43) as another minor isomeric product in a mixture with (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (Example 1). This was separated by SFC (Column: Princeton 4-FBSA (250×21 mm, 5 im), Mobile Phase: 40:60 (A:B), A: Liquid CO2, B: Methanol (20 mM NH3), Flow Rate: 50 mL/min, Column/Oven temp.=40 C, Wavelength=244 nm, 135.85 mg/injection, Cycle time=4.5 min, End of run time=6.25 min, 200-206 bar inlet pressure, BPR=100 bar) to yield (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (EXAMPLE 43) as a white solid. ¹H NMR (400 MHz, CD3OD) (collected from its TFA salt after lyophilization) δ ppm 7.73 (d, J=8.6 Hz, 1H), 7.17 (dd, J=8.5, 2.2 Hz, 1H), 7.10 (d, J=2.2 Hz, 1H), 7.05 (dd, J=8.1, 1.9 Hz, 1H), 6.90-6.98 (m, 2H), 4.41-4.47 (m, 3H), 4.01-4.08 (m, 3H), 3.61-3.83 (m, 4H), 3.44-3.49 (m, 1H), 3.24-3.26 (m, 1H), 3.06-3.09 (m, 1H), 2.91 (s, 6H), 2.75-2.85 (m, 2H), 2.45-2.50 (m, 2H), 1.85-2.10 (m, 5H), 1.49-1.81 (m, 6H), 1.40-1.49 (m, 3H), 1.37 (d, J=7.2 Hz, 3H), 1.16-1.33 (m, 2H), 1.02 (d, J=6.8 Hz, 3H). MS (ESI, +ve) m/z 714.2 [M+H]⁺.

Examples 97 and 96 (1S,3′R,6′R,7′S,8′E,11′5,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,8′E,11′5,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,8′E,11′5,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE (Examples 96 and 97)

Step 1: (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAENE]-7′-CARBALDEHYDE 13′,13′-DIOXIDE and (1S,3′R,6′R,7′R,8′E,11′5,12′R)-6-CHLORO-11′,12′-DIMETHYL-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAENE]-7′-CARBALDEHYDE 13′,13′-DIOXIDE

To a stirred solution of (1S,3′R,6′R,8′E,11′S,12′R)-6-chloro-11′,12′-dimethyl-3,4-dihydro-2H,7′H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,2 4]tetraene]-7′,15′-dione 13′,13′-dioxide (200 mg, 0.335 mmol) and trimethylsulfonium iodide (71.8 mg, 0.352 mmol) in dimethyl sulfoxide (2.0 mL) was dropwise added potassium tert-butoxide, 1.0 m solution in tetrahydrofuran (0.837 mL, 0.837 mmol) under argon over 5 min. The resulting mixture was stirred at ambient temperature for 15 min. The crude reaction mixture was directly loaded onto a silica gel precolumn previously covered with a layer of ammonium chloride and subjected to combi-flash column chromatography on a 12-g ISCO Gold eluting with EtOAc/Hexanes (15 min from 20 to 100% and 10 min at 100%) to give, as minor products, an impure epimeric mixture of (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraene]-7′-carbaldehyde 13′,13′-dioxide and (1S,3′R,6′R,7′R,8′E,11′5,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraene]-7′-carbaldehyde 13′,13′-dioxide (50 mg) as a white solid. It was directly taken onto the next step without further purification. MS (ESI, +ve) m/z 611.4 [M+H]⁺.

Step 2: (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-CHLORO-7′-(CIS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRA CYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(DIMETHYLAMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[8,16,18,24]TETRAEN]-15′-ONE 13′,13′-DIOXIDE (Examples 96 and 97)

An impure mixture of (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraene]-7′-carbaldehyde 13′,13′-dioxide and (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraene]-7′-carbaldehyde 13′,13′-dioxide (24 mg, 0.039 mmol), 2-(dimethylamino)propane-1,3-diol (70.2 mg, 0.589 mmol), and 4-methylbenzene sulfonic acid, monohydrate (116 mg, 0.609 mmol) in toluene (40 mL) in a 50-mL round-bottomed flask equipped with a Dean-Stark condenser was heated at reflux for 4 h. Both the precipitate and the toluene layer showed the presence of the desired products although weak in signal. The crude mixture was left at rt overnight before directly loaded in DCM/MeOH onto a silica gel precolumn (25 g) previously covered with a layer of sodium bicarbonate and subjected to combi-flash column chromatography on a 4-g ISCO GOLD eluting with MeOH/DCM to give two isomeric products: (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6.˜0˜19,24˜]pentacosa[8,16,18,2 4]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-7′-(Trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-chloro-7′-(Trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,2 4]tetraen]-15′-one 13′,13′-dioxide (Example 97) as an off-white solid. It was the second eluting isomer off of silica gel column. ¹H NMR (400 MHz, CHLOROFORM-d) δ 7.70 (d, J=8.61 Hz, 1H), 7.19 (dd, J=2.25, 8.51 Hz, 1H), 7.09 (d, J=2.15 Hz, 1H), 6.84-6.96 (m, 3H), 5.65-5.77 (m, 1H), 5.48-5.58 (m, 1H), 4.39 (br d, J=3.91 Hz, 3H), 4.31 (q, J=7.04 Hz, 1H), 4.04-4.11 (m, 2H), 3.83-3.95 (m, 2H), 3.79 (br d, J=15.26 Hz, 1H), 3.70 (br d, J=14.28 Hz, 1H), 3.23 (d, J=14.28 Hz, 1H), 2.91-2.99 (m, 1H), 2.73-2.81 (m, 2H), 2.55-2.69 (m, 6H), 2.38-2.48 (m, 3H), 1.55-2.12 (m, 9H), 1.48 (d, J=7.24 Hz, 3H), 1.20-1.42 (m, 3H), 1.04 (d, J=6.65 Hz, 3H). MS (ESI, +ve) m/z 71.2. [M+H]⁺;

and (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-1′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,2 4]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′R,8′E,11′5,12′R)-6-chloro-7′-(cis-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′S,8′E,11′S,12′R)-6-chloro-7′-(Trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,2 4]tetraen]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′R,8′E,11′S,12′R)-6-chloro-7′-(Trans-5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[8,16,18,24]tetraen]-15′-one 13′,13′-dioxide (Example 96) as an off-white solid. It was the first eluting isomer off of silica gel coumn. ¹H NMR (400 MHz, CHLOROFORM-d) δ 7.73 (d, J=8.61 Hz, 1H), 7.43 (s, 1H), 7.25 (br s, 1H), 7.16 (dd, J=2.25, 8.51 Hz, 1H), 7.07 (d, J=2.15 Hz, 1H), 6.85 (d, J=8.22 Hz, 1H), 5.83 (br dd, J=8.90, 16.33 Hz, 1H), 5.49 (td, J=4.38, 16.09 Hz, 1H), 4.77 (d, J=3.13 Hz, 1H), 4.50-4.69 (m, 2H), 4.19 (br dd, J=1.66, 13.20 Hz, 1H), 4.02-4.11 (m, 3H), 3.96 (br d, J=14.87 Hz, 1H), 3.78-3.86 (m, 1H), 3.69 (br d, J=14.08 Hz, 1H), 3.18 (br d, J=14.28 Hz, 1H), 3.01 (s, 6H), 2.73-2.89 (m, 4H), 2.51-2.61 (m, 2H), 2.16-2.26 (m, 2H), 1.38-2.11 (m, 7H), 1.33 (d, J=7.04 Hz, 3H), 1.14-1.29 (m, 3H), 1.05 (d, J=6.65 Hz, 3H). MS (ESI, +ve) m/z 712.2 [M+H]⁺.

Examples 41, 42, and 46 (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′5,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Examples 41 and 42) and (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(CIS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-7′-(CIS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(ETHYL(METHYL) AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Example 46)

Step 1: (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′5,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(METHYLAMINO)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Examples 41 and 42)

The title compounds were prepared in an analogous manner to that described in Example 1 using 2-(methylamino)-1,3-propanediol. Examples 41 and 42 were the only stereoisomers isolated. Example 42 was the first eluting epimer off of preparative reverse-phase HPLC (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method). MS (ESI, +ve ion) m/z 700.3 (M+H)⁺.

Step 2. (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(CIS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′5,12′R)-6-CHLORO-7′-(CIS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(ETHYL(METHYL)AMINO)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Examples 46)

To a 25-mL round-bottomed flask was added Example 42 (65 mg, 0.093 mmol) and acetaldehyde (0.026 mL, 0.464 mmol) in DCM (0.5 mL). The reaction mixture was stirred at rt for 1 h before sodium triacetoxyborohydride (98 mg, 0.464 mmol) was added. The reaction was stirred overnight. The reaction mixture was diluted with a saturated aqueous solution of NH₄Cl (5 mL) and extracted with EtOAc (2×10 mL). The combined organics were washed with a saturated aqueous solution of NaCl (10 mL), dried over MgSO₄, filtered, and concentrated in vacuo. The residue was purified by preparative reverse-phase HPLC (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method) to give (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′R,11′5,12′R)-6-chloro-7′-(cis-5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′S,11′5,12′R)-6-chloro-7′-(trans-5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)-1′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide OR (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans-5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide. (Example 46) ¹H NMR (400 MHz, CDCl₃) δ ppm 7.71 (d, J=8.6 Hz, 1H), 7.15-7.24 (m, 1H), 7.05-7.14 (m, 1H), 6.88-7.01 (m, 3H), 4.40-4.58 (m, 2H), 4.05-4.28 (m, 4H), 3.90-4.03 (m, 2H), 3.59-3.86 (m, 3H), 3.50 (br s, 1H), 3.22 (br d, J=14.5 Hz, 1H), 2.89-3.10 (m, 3H), 2.84 (br d, J=7.4 Hz, 1H), 2.64-2.81 (m, 5H), 2.31-2.59 (m, 4H), 2.23-2.29 (m, 1H), 1.89-2.07 (m, 5H), 1.70-1.84 (m, 4H), 1.25-1.64 (m, 7H, with water residue), 0.99-1.08 (m, 4H), MS (ESI, +ve ion) m/z 728.3 (M+H)⁺.

Example 59 (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE

Step 1: (1S,3′R,6′R, 7′S,11′S,12′R)-6-CHLORO-7′-(CIS-5-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE and (1S,3′R,6′R, 7′R,11′S,12′R)-6-CHLORO-7′-(CIS-5-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE and (1S,3′R,6′R, 7′S,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE and (1S,3′R,6′R, 7′R,11′S,12′R)-6-CHLORO-7′-(TRANS-5-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-DIOXAN-2-YL)-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE

The title compounds were prepared in an analogous manner to that described in Example 1 using 2-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-propanediol. The crude product was purified by chromatography through a Redi-Sep pre-packed silica gel column, eluting with MeOH/CD₂Cl₂, to provide the title compounds in 87% yield as a white solid. MS (ESI, +ve ion) m/z 804.3 (M+H)⁺.

Step 2: (1S,3′R,6′R,7′S,115′,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(CIS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-7′-(TRANS-5-(2-OXA-6-AZASPIRO[3.3]HEPT-6-YL)-1,3-DIOXAN-2-YL)-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE

To a 25-mL round-bottomed flask was added (S,3′R,6′R, 7′5,11′S,12′R)-6-chloro-7′-(cis-5-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide and (1S,3′R,6′R, 7′R,11′S,12′R)-6-chloro-7′-(cis-5-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜. 0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide and (1S,3′R,6′R, 7′S,11′S,12′R)-6-chloro-7′-(trans-5-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-dioxan-2-yl)-11,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide and (1S,3′R,6′R, 7′R,11′S,12′R)-6-chloro-7′-(trans-5-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (40 mg, 0.050 mmol) followed by 2-methyl THF (5.0 mL). At 0° C., potassium tert-butoxide, 1.0 M solution in tetrahydrofuran (0.149 mL, 0.149 mmol) was added. The reaction was stirred overnight. The reaction mixture was diluted with a saturated aqueous solution of NH₄Cl (5 mL) and extracted with CH₂Cl₂ (2×10 mL). The combined organics were washed with satd NaCl (10 mL), dried over MgSO₄, filtered, and concentrated in vacuo. The residue was subjected to preparative reverse-phase HPLC (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method) to yield (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-7′-(cis-5-(2-oxa-6-azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide or (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-7′-(cis-5-(2-oxa-6-azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide or (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-7′-(trans-5-(2-oxa-6-azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide or (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-7′-(trans-5-(2-oxa-6-azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (Example 59) as a white solid. It was the first eluting stereoisomer. ¹H NMR (400 MHz, CD₃OD) δ ppm 7.73 (d, J=8.4 Hz, 1H), 7.13-7.25 (m, 1H), 7.11 (s, 1H), 7.02-7.08 (m, 1H), 6.92-6.98 (m, 2H), 4.79-4.83 (m, 4H, with water residue), 4.33-4.55 (m, 3H), 4.22-4.31 (m, 1H), 3.95-4.18 (m, 5H), 3.77 (br d, J=14.7 Hz, 1H), 3.57-3.70 (m, 1H), 3.35-3.56 (m, 2H), 3.23-3.34 (m, 3H), 2.90-3.04 (m, 1H), 2.71-2.86 (m, 2H), 2.41-2.54 (m, 2H), 2.07 (br d, J=12.9 Hz, 1H), 1.84-2.02 (m, 4H), 1.78 (br dd, J=17.2, 7.6 Hz, 1H), 1.59-1.72 (m, 2H), 1.47-1.54 (m, 2H), 1.29-1.46 (m, 6H), 1.01 (br d, J=6.8 Hz, 3H). MS (ESI, +ve ion) m/z 768.2 (M+H)⁺.

Examples 44, 45, 17, and 18 2-(TRANS-2-((1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-13′,13′-DIOXIDO-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-7′-YL)-1,3-DIOXAN-5-YL)-1H-ISOINDOLE-1,3(2H)-DIONE OR 2-(TRANS-2-((1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-13′,13′-DIOXIDO-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-7′-YL)-1,3-DIOXAN-5-YL)-1H-ISOINDOLE-1,3(2H)-DIONE (Examples 44 and 45) and (1S,3′R,6′R,7′S,11′S,12′R)-7′-(TRANS-5-AMINO-1,3-DIOXAN-2-YL)-6-CHLORO-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE and (1S,3′R,6′R,7′R,11′S,12′R)-7′-(TRANS-5-AMINO-1,3-DIOXAN-2-YL)-6-CHLORO-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Examples 17 and 18)

Step 1: 2-(TRANS-2-((1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-13′,13′-DIOXIDO-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-7′-YL)-1,3-DIOXAN-5-YL)-1H-ISOINDOLE-1,3(2H)-DIONE OR 2-(TRANS-2-((1S,3′R,6′R,7′R,11′S,12′R)-6-CHLORO-11′,12′-DIMETHYL-13′,13′-DIOXIDO-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-7′-YL)-1,3-DIOXAN-5-YL)-1H-ISOINDOLE-1,3(2H)-DIONE (Examples 44,45)

The title compounds were prepared in an analogous manner to that described in Example 1 using 2-(1,3-dihydroxy-2-propanyl)-1H-isoindole-1,3(2H)-dione. The crude product was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column, eluting with a gradient of 0% to 100% EtOAc in hexane, to provide a mixture of two epimeric products in 93% yield as a white solid. A portion of this was subjected to preparative reverse-phase HPLC (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method) to give the title compounds. MS (ESI, +ve ion) m/z 816.3 (M+H)⁺.

Step 2: (1S,3′R,6′R,7′S,11′,12′R)-7′-(TRANS-5-AMINO-1,3-DIOXAN-2-YL)-6-CHLORO-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE OR (1S,3′R,6′R,7′R,11′S,12′R)-7′-(TRANS-5-AMINO-1,3-DIOXAN-2-YL)-6-CHLORO-11′,12′-DIMETHYL-3,4-DIHYDRO-2H,15′H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIEN]-15′-ONE 13′,13′-DIOXIDE (Examples 17 and 18)

To a 25-mL round-bottomed flask was added at rt a mixture of 2-(trans-2-((1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-13′,13′-dioxido-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-7′-yl)-1,3-dioxan-5-yl)-1H-isoindole-1,3(2H)-dione and 2-(trans-2-((1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-13′,13′-dioxido-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-7′-yl)-1,3-dioxan-5-yl)-1H-isoindole-1,3(2H)-dione (150 mg, 0.184 mmol) followed by DCE (3.0 mL) and 1-methyl hydrazine (0.097 mL, 1.837 mmol). The resulting mixture was stirred at 40° C. overnight. The mixture was quenched with 2 N aqueous HCl (1.0 mL) and then concentrated. The residue was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column (12 g), eluting with a gradient of 0% to 100% heptane in 20% MeOH in EtOAc, to give an impure product mixture which was further purified by preparative reverse-phase HPLC (Gemini™ Prep C18 5 μm column; Phenomenex, Torrance, Calif.; gradient elution of 5 to 95% MeCN in water, where both solvents contain 0.1% TFA, 35 min method) to give (1S,3′R,6′R,7′S,11′S,12′R)-7′-(trans-5-amino-1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide or (1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-amino-1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl-3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]trien]-15′-one 13′,13′-dioxide (Examples 17 and 18) as white solids. Example 17 was the first eluting stereoisomer off of HPLC. MS (ESI, +ve ion) m/z 686.2 (M+H)⁺.

Synthesis of Intermediates (1S,3′R,6′R,7′S,11′S,12′R)-6-CHLORO-7′,11′,12′-TRIMETHYL-15′-OXO-3,4-DIHYDRO-2H-SPIRO[NAPHTHALENE-1,22′-[20]OXA[13]THIA[1,14]DIAZATETRACYCLO[14.7.2.0˜3,6˜.0˜19,24˜]PENTACOSA[16,18,24]TRIENE]-7′-CARBALDEHYDE 13′,13′-DIOXIDE

To a stirred ice-cooled solution of (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide and (1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′-dimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide (83 mg, 0.135 mmol) in DCM (3.5 mL) was added potassium tert-butoxide, 1.0 m solution in tetrahydrofuran (0.541 mL, 0.541 mmol) followed by methyl iodide, reagent plus (0.084 mL, 1.354 mmol). The resulting mixture was stirred at 0° C. for a period of 40 min and at ambient temperature for 2.5 h. The crude mixture was directly loaded onto a silica gel precolumn (25 g) previously covered with a layer of sodium bicarbonate and subjected to combi-flash column chromatography on a 12-g ISCO Gold eluting with EtOAc/Hexanes (20 min from 0 to 100%) to give (1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′,11′,12′-trimethyl-15′-oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′-[20]oxa[13]thia[1,14]diazatetracyclo[14.7.2.0˜3,6˜.0˜19,24˜]pentacosa[16,18,24]triene]-7′-carbaldehyde 13′,13′-dioxide (60 mg, 0.096 mmol, 70.7% yield) as a white solid. MS (ESI, +ve) m/z 627.3 [M+H]⁺.

2-(1-AZETIDINYL)-1,3-PROPANEDIOL 4-METHYLBENZENESULFONIC Acid Salt

Step 1: 1-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)AZETIDINE

To a 250-mL round-bottomed flask was added 2,2-dimethyl-1,3-dioxan-5-one (1.0 g, 7.68 mmol, Matrix Scientific, Columbia, S.C.) and azetidine (0.673 ml, 9.99 mmol) followed by DCM (38.4 mL). The mixture was stirred for 1 h before sodium triacetoxyborohydride (2.117 g, 9.99 mmol) was added and the resulting mixture was stirred overnight. The reaction was quenched with methanol and diluted with a saturated aqueous solution of NaHCO₃ (30 mL) and extracted with CH₂Cl₂ (2×30 mL). The combined organics were washed with a saturated aqueous solution of NaCl (20 mL), dried over MgSO₄, filtered and concentrated in vacuo. The residue was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column (40 g), eluting with a gradient of 0% to 100% heptane in EtOAc/EtOH (3:1) with 10% ammonia, to provide 1-(2,2-dimethyl-1,3-dioxan-5-yl)azetidine (1.12 g, 6.54 mmol, 85% yield) as a yellow oil. MS (ESI, +ve ion) m/z 172.3 (M+H)⁺.

Step 2: 2-(1-AZETIDINYL)-1,3-PROPANEDIOL 4-METHYLBENZENESULFONIC ACID SALT

To a 50-mL round-bottomed flask were added p-toluenesulfonic acid monohydrate (1.369 g, 7.19 mmol) and 1-(2,2-dimethyl-1,3-dioxan-5-yl)azetidine (1.12 g, 6.54 mmol) followed by water (32.7 ml). The mixture was stirred at 50° C. for 2 h. The volatiles were removed under vacuum to give 2-(1-azetidinyl)-1,3-propanediol 4-methylbenzenesulfonic acid salt (2.5 g, 8.2 mmol, 126% yield). ¹H NMR (400 MHz, CD₃OD) δ ppm 7.71 (m, J=8.0 Hz, 2H), 7.24 (m, J=8.0 Hz, 2H), 4.28-4.46 (m, 2H), 4.05-4.23 (m, 2H), 3.69-3.80 (m, 4H), 3.30-3.36 (m, 1H), 2.51-2.73 (m, 1H), 2.28-2.39 (m, 4H). MS (ESI, +ve ion) m/z 132.2 (M+H)⁺.

2-(METHYLAMINO)-1,3-PROPANEDIOL

Step 1: 2-METHYL-2-PROPANYL (2,2-DIMETHYL-1,3-DIOXAN-5-YL)METHYLCARBAMATE

To a 250-mL round-bottomed flask was added 2,2-dimethyl-1,3-dioxan-5-one (0.8 g, 6.15 mmol, Matrix Scientific, Columbia, S.C.) followed by DCM (30.7 ml) and methanamine in THF (3.69 ml, 7.38 mmol). The mixture was stirred at rt for 1 h before sodium triacetoxyborohydride (1.694 g, 7.99 mmol) was added and the resulting mixture was stirred overnight. The reaction was quenched with methanol and di-tert-butyl dicarbonate (1.427 ml, 6.15 mmol) was added. The resulting mixture was stirred at rt for 4 h before diluted diluted with a saturated aqueous solution of NaHCO₃ (20 mL) and extracted with CH₂Cl₂ (2×20 mL). The combined organics were washed with 1 N aqueous HCl to remove excess amines, dried over MgSO₄, and concentrated in vacuo. The residue was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column (40 g), eluting with a gradient of 0% to 70% EtOAc in hexane, to provide 2-methyl-2-propanyl (2,2-dimethyl-1,3-dioxan-5-yl)methylcarbamate (1.22 g, 4.97 mmol, 81% yield). MS (ESI, +ve ion) m/z 268.2 (M+Na)⁺.

Step 2: 2-(METHYLAMINO)-1,3-PROPANEDIOL

To a 25-mL round-bottomed flask was added 2-methyl-2-propanyl (2,2-dimethyl-1,3-dioxan-5-yl)methylcarbamate (600 mg, 2.446 mmol) followed by THF (12.2 mL) and water (1.22 mL). Hydrogen chloride, 4.0 M solution in 1,4-dioxane (1.834 mL, 7.34 mmol) was added and the resulting solution was stirred overnight. Upon completion of the reaction, the volatiles were removed in vacuo. The residue was dissolved in an 1:1 (v/v) mixture of chloroform and isopropanol. To this solution was added sodium bicarbonate powder (2 g). The mixture was stirred for 1 h and filtered. The filtrate was concentrated in vacuo to give 2-(methylamino)-1,3-propanediol (230 mg, 2.19 mmol, 89% yield). ¹H NMR (400 MHz, CD₃OD) δ ppm 3.83 (dd, J=12.0, 4.4 Hz, 2H), 3.73 (dd, J=12.0, 6.2 Hz, 2H), 3.17-3.24 (m, 1H), 2.75 (s, 3H). MS (ESI, +ve ion) m/z 106.2 (M+H)⁺.

2-(1,3-DIHYDROXY-2-PROPANYL)-1H-ISOINDOLE-1,3(2H)-DIONE

Step 1: 2-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)-1H-ISOINDOLE-1,3(2H)-DIONE

To a 50-mL round-bottomed flask were added 2,2-dimethyl-1,3-dioxan-5-ol (1.0 g, 7.57 mmol), triphenylphosphine (2.98 g, 11.35 mmol, Eanmine) and phthalimide (1.7 g, 11.35 mmol) followed by THF (30.3 ml). To this stirred ice-cooled solution was slowly added diethyl azodicarboxylate (4.48 ml, 9.84 mmol). The resulting mixture was stirred overnight before diluted with 1 N aqueous HCl (5 mL) and extracted with EtOAc (2×10 mL). The combined organics were washed with a saturated aqueous solution of NaCl (10 mL), dried over MgSO₄, filtered, and concentrated in vacuo. The residue was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column (12 g), eluting with a gradient of 0% to 40% EtOAc in hexane, to provide 2-(2,2-dimethyl-1,3-dioxan-5-yl)-1H-isoindole-1,3(2H)-dione. MS (ESI, +ve ion) m/z 284.0 (M+Na)⁺.

Step 2: 2-(1,3-DIHYDROXY-2-PROPANYL)-1H-ISOINDOLE-1,3(2H)-DIONE

To a stirred solution of 2-(2,2-Dimethyl-1,3-dioxan-5-yl)-1H-isoindole-1,3(2H)-dione in THF (3.0 mL) and was added 0.3 mL of 5 N aqueous HCl. The mixture was stirred at rt for half an hour. The reaction mixture was diluted with water (5 mL) and extracted with EtOAc (2×10 mL). The combined organics were washed with a saturated aqueous solution of NaCl (5 mL), dried over MgSO₄, filtered and concentrated in vacuo. The residue was absorbed onto a plug of silica gel and purified by chromatography through a Redi-Sep pre-packed silica gel column (12 g), eluting with a gradient of 0% to 20% methanol in EtOAc, to provide 2-(1,3-dihydroxy-2-propanyl)-1H-isoindole-1,3(2H)-dione as a white solid. ¹H NMR (400 MHz, CDCl₃) δ ppm 7.85-7.90 (m, 2H), 7.73-7.80 (m, 2H), 4.44-4.50 (m, 1H), 4.03-4.14 (m, 4H). MS (ESI, +ve ion) m/z 222.1 (M+H)⁺.

2-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-PROPANEDIOL

Step 1: 6-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)-2-OXA-6-AZASPIRO[3.3]HEPTANE

To a 250-mL round-bottomed flask was added 2,2-dimethyl-1,3-dioxan-5-one (0.6 g, 4.61 mmol, Matrix Scientific, Columbia, S.C.) and 2-oxa-6-azaspiro[3.3]heptane oxalic acid salt (1.134 g, 5.99 mmol, Advanced ChemTech) followed by 2-methyTHF (23.05 ml) and TEA (1.414 ml, 10.14 mmol). The mixture was stirred at rt for 1 h before sodium triacetoxyborohydride (1.270 g, 5.99 mmol) was added portionwise over a period of 5 h. The reaction was further stirred overnight before diluted with a saturated aqueous solution of NaHCO₃ (20 mL) and extracted with CH₂Cl₂ (2×20 mL). The combined organics were washed with a satd aqueous solution of NH₄Cl (10 mL), dried over MgSO₄, filtered, and concentrated in vacuo. The residue was absorbed onto a plug of silica gel and purified by chromatography through an ISCO gold column (24 g), eluting with a gradient of 0% to 100% heptane in EtOAc/EtOH (3:1) with 10% ammonia, to provide 6-(2,2-dimethyl-1,3-dioxan-5-yl)-2-oxa-6-azaspiro[3.3]heptane (0.253 g, 1.186 mmol, 25.7% yield) as light-yellow solid. MS (ESI, +ve ion) m/z 214.2 (M+H)⁺.

Step 2: 2-(3-(CHLOROMETHYL)-3-(HYDROXYMETHYL)-1-AZETIDINYL)-1,3-PROPANEDIOL

To a stirred solution of 6-(2,2-dimethyl-1,3-dioxan-5-yl)-2-oxa-6-azaspiro[3.3]heptane (0.23 g, 1.078 mmol) in methanol (5.39 ml) in a 15-mL round-bottomed flask was added at rt hydrogen chloride, 4 M in 1,4-dioxane (0.297 ml, 1.186 mmol). The reaction was stirred at rt for 2 h. The reaction mixture was concentrated in vacuo. The residue was re-dissolved in DCM and stirred with silicycle Si-carbonate powder (3 g) overnight. The solid was filtered off and the filtrate was dried under vacuum to give 2-(3-(chloromethyl)-3-(hydroxymethyl)-1-azetidinyl)-1,3-propanediol (0.2 g, 0.95 mmol, 88% yield). ¹H NMR (400 MHz, CD₃OD) δ ppm 3.87 (s, 2H), 3.75 (s, 2H), 3.53-3.68 (m, 4H), 3.28-3.37 (m, 5H, overlap with solvent peak), 2.52 (quin, J=5.0 Hz, 1H). MS (ESI, +ve ion) m/z 210.2 (M+H)⁺.

2-METHOXYPROPANE-1,3-DIOL HYDROCHLORIDE

Step 1: 5-METHOXY-2,2-DIMETHYL-1,3-DIOXANE

KHMDS (1.0 M in THF; 1.77 mL, 1.77 mmol) was added to a colorless solution of 2,2-dimethyl-1,3-dioxan-5-ol (0.117 g, 0.885 mmol; Enamine Ltd, Monmouth Jet., N.J.) and methyl iodide (0.066 mL, 1.1 mmol) in tetrahydrofuran (9 mL) at ambient temperature when an off-white precipitate formed. The reaction mixture was stirred at ambient temperature for 1 h. The reaction mixture was diluted with EtOAc (75 mL), added to a separatory funnel, and washed with saturated, aqueous ammonium chloride (75 mL) and brine (75 mL); the organic layer was separated, dried over anhydrous Na₂SO₄, and concentrated in vacuo to give 5-methoxy-2,2-dimethyl-1,3-dioxane as a liquid. This was used directly in the next step. ¹H NMR (400 MHz, CDCl₃) δ 3.99 (dd, J=11.9, 4.1 Hz, 2H) 3.77 (dd, J=12.0, 6.0 Hz, 2H) 3.39 (s, 3H) 3.26-3.35 (m, 1H) 1.43 (d, J=8.8 Hz, 6H). MS (ESI, +ve) m/z: 147.2 (M+1)⁺.

Step 2: 2-METHOXYPROPANE-1,3-DIOL HYDROCHLORIDE

A solution of the crude product from Step 1 and HCl (5 M, aq., 0.531 ml, 2.66 mmol in tetrahydrofuran (9 mL) was stirred at ambient temperature for 30 min. The reaction mixture was concentrated, dissolved in EtOAc/MeOH, dried over sodium sulfate, filtered, and concentrated to give 2-methoxypropane-1,3-diol hydrochloride (79 mg, 0.74 mmol, 84% yield in two steps) as a yellow oil. MS (ESI, +ve) m/z: 107.2 (M+1)+.

(R)-3-(DIMETHYLAMINO)PROPANE-1,2-DIOL 4-METHYLBENZENESULFONATE

Step 1: (R)-1-(2,2-DIMETHYL-1,3-DIOXOLAN-4-YL)-N,N-DIMETHYLMETHANAMINE

Sodium triacetoxyhydroborate (2.21 g, 10.4 mmol) was added to a mixture of (S)-2,2-dimethyl-1,3-dioxolane-4-carboxaldehyde in DCM (1.35 mL, 5.20 mmol; Oakwood Products, Inc., Estill, S.C.), dimethylamine hydrochloride (2.12 g, 26.0 mmol), and TEA (3.63 ml, 26.0 mmol) in dichloromethane (13 mL) and methanol (1 mL) at ambient temperature, and the slurry was stirred at ambient temperature for 2 h. The reaction mixture was diluted with DCM (100 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (2×100 mL) and brine (100 mL); the organic layer was separated, dried over anhydrous Na₂SO₄, and concentrated in vacuo to give (R)-1-(2,2-dimethyl-1,3-dioxolan-4-yl)-N,N-dimethylmethanamine (316 mg, 1.99 mmol, 38% yield) as a pale yellow milky oil. This was used directly in the next step. MS (ESI, +ve) m/z: 160.2 (M+1)+.

Step 2: (R)-3-(DIMETHYLAMINO)PROPANE-1,2-DIOL 4-METHYLBENZENESULFONATE

A solution of the crude product from Step 1 and 4-methylbenzenesulfonic acid hydrate (0.445 g, 2.341 mmol) in tetrahydrofuran (13 mL) and water (2 mL) was stirred at 50° C. for 8 h. The reaction mixture was concentrated, dissolved in EtOAc/MeOH, dried over sodium sulfate, and concentrated to give (R)-3-(dimethylamino)propane-1,2-diol 4-methylbenzenesulfonate (194 mg, 0.666 mmol, 12.8% yield in two steps) as an amber oil. ¹H NMR (400 MHz, MeOH-d4) δ 4.90 (s, 6H) 3.99 (dtd, J=9.9, 4.9, 4.9, 3.7 Hz, 1H) 3.50-3.59 (m, 2H) 3.11-3.24 (m, 2H). MS (ESI, +ve) m/z: 120.2 (M+1)⁺.

(S)-3-(DIMETHYLAMINO)PROPANE-1,2-DIOL 4-METHYLBENZENESULFONATE

Step 1: (S)-1-(2,2-DIMETHYL-1,3-DIOXOLAN-4-YL)-N,N-DIMETHYLMETHANAMINE

Sodium triacetoxyhydroborate (1.63 g, 7.68 mmol) was added to a solution of (R)-2,2-dimethyl-1,3-dioxolane-4-carbaldehyde (0.50 g, 3.8 mmol), dimethylamine hydrochloride (1.57 g, 19.2 mmol), and triethylamine (2.68 mL, 19.2 mmol) in dichloromethane (24 mL) and MeOH (3 mL) at ambient temperature. The slurry was stirred for 2 h. The reaction mixture was diluted with EtOAc (150 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (2×75 mL); the organic layer was separated, dried over anhydrous sodium sulfate, and concentrated in vacuo to give (S)-1-(2,2-dimethyl-1,3-dioxolan-4-yl)-N,N-dimethylmethanamine (376 mg, 2.36 mmol, 62% yield) as an oil. This was used directly in the next step. MS (ESI, +ve) m/z: 160.2 (M+1)+.

Step 2: (S)-3-(DIMETHYLAMINO)PROPANE-1,2-DIOL 4-METHYLBENZENESULFONATE

A colorless solution of the crude product from Step 1 and 4-methylbenzenesulfonic acid hydrate (0.512 g, 2.69 mmol) in tetrahydrofuran (24 mL)/water (5 mL) was stirred at ambient temperature for 16 h then at 50° C. for 4 h. More PTSA was added, and the reaction mixture was stirred at 60° C. for 16 h. The reaction mixture was concentrated, redissolved in EtOAc/MeOH, dried with sodium sulfate, decanted, and concentrated to give (S)-3-(dimethylamino)propane-1,2-diol 4-methylbenzenesulfonate (882 mg, 3.03 mmol, 79% yield in two steps) as a colorless oil. ¹H NMR (400 MHz, MeOH-d6) δ 4.92 (s, 6H) 3.93-4.04 (m, 1H) 3.49-3.60 (m, 2H) 3.11-3.26 (m, 2H). MS (ESI, +ve) m/z: 120.2 (M+1)+.

2-(3-FLUOROAZETIDIN-1-YL)PROPANE-1,3-DIOL 4-METHYLBENZENESULFONATE

Step 1: 1-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)-3-FLUOROAZETIDINE

Sodium triacetoxyhydroborate (1.63 g, 7.68 mmol) was added to a solution of 2,2-dimethyl-1,3-dioxan-5-one (0.50 g, 3.84 mmol; Matrix Scientific, Columbia, S.C.), 3-fluoroazetidine hydrochloride (0.492 g, 4.41 mmol; PharmBlock, Inc., Sunnyvale, Calif.), and TEA (0.616 ml, 4.42 mmol) in dichloromethane (24 mL)/MeOH (3 mL) at ambient temperature. The colorless solution was stirred for 2 h. The reaction mixture was diluted with EtOAc (150 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (2×75 mL); the organic layer was separated, dried over anhydrous sodium sulfate, and concentrated in vacuo to give 1-(2,2-dimethyl-1,3-dioxan-5-yl)-3-fluoroazetidine (523 mg, 2.76 mmol, 72% yield) as a colorless oil. This was used directly in the next step. MS (ESI, +ve) m/z: 190.2 (M+1)+.

Step 2: 2-(3-FLUOROAZETIDIN-1-YL)PROPANE-1,3-DIOL 4-METHYLBENZENESULFONATE

A colorless solution of the crude product from Step 1 and 4-methylbenzenesulfonic acid hydrate (0.512 g, 2.69 mmol) in tetrahydrofuran (24 mL) and water (5 mL) was stirred at 60° C. for 16 h. The reaction mixture was concentrated to give an oil. It was redissolved in EtOAc/MeOH, dried with sodium sulfate, decanted, and concentrated to give 2-(3-fluoroazetidin-1-yl)propane-1,3-diol 4-methylbenzenesulfonate (0.89 g, 72% yield in two steps) as a colorless oil. MS (ESI, +ve) m/z: 173.1 (M+1)+.

2-(3-CHLOROAZETIDIN-1-YL)PROPANE-1,3-DIOL 4-METHYLBENZENESULFONATE

Step 1: 3-CHLORO-1-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)AZETIDINE

Sodium triacetoxyhydroborate (1.48 g, 6.96 mmol) was added to a solution of 2,2-dimethyl-1,3-dioxan-5-one (0.453 g, 3.48 mmol; Matrix Scientific, Columbia, S.C.), 3-chloroazetidine hydrochloride (0.535 g, 4.18 mmol; Synthonix, Wake Forest, N.C.), and TEA (0.582 mL, 4.18 mmol) in dichloromethane (22 mL) and MeOH (3 mL) at ambient temperature. The colorless solution was stirred for 3 h. The reaction mixture was concentrated, diluted with EtOAc (50 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (2×75 mL); the organic layer was separated, dried over anhydrous sodium sulfate, and concentrated in vacuo as a colorless oil. This was used directly in the next step. MS (ESI, +ve) m/z: 206.0 (M+1)+.

Step 2: 2-(3-CHLOROAZETIDIN-1-YL)PROPANE-1,3-DIOL 4-METHYLBENZENESULFONATE

A solution of the crude product from Step 1 and 4-methylbenzenesulfonic acid hydrate (0.463 g, 2.44 mmol) in tetrahydrofuran (22 mL) and water (3 mL) was stirred at 60° C. for 18 h. The reaction mixture was concentrated, dissolved in MeOH, dried over sodium sulfate, decanted, and concentrated to give 2-(3-chloroazetidin-1-yl)propane-1,3-diol 4-methylbenzenesulfonate (765 mg, 2.27 mmol, 65% yield in two steps) as a beige solid. ¹H NMR (400 MHz, DMSO-d6) δ4.79-4.90 (m, 3H) 4.40-4.62 (m, 3H) 4.11-4.25 (m, 1H) 3.55-3.73 (m, 4H) 3.38-3.53 (m, 1H). MS (ESI, +ve) m/z: 173.0 (M+1)+.

2-(3-HYDROXYAZETIDIN-1-YL)PROPANE-1,3-DIOL

Step 1: 1-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)AZETIDIN-3-OL

Sodium triacetoxyhydroborate (2.39 g, 11.3 mmol) was added to a solution of 2,2-dimethyl-1,3-dioxan-5-one (0.734 g, 5.64 mmol; Matrix Scientific, Columbia, S.C.), azetidin-3-ol hydrochloride (0.741 g, 6.77 mmol; Oakwood Products, Inc., Estill, S.C.), and TEA (0.943 mL, 6.77 mmol) in dichloromethane (35 mL) and MeOH (10 mL) at ambient temperature. The slurry was stirred for at ambient temperature for 16 h. The reaction mixture was concentrated, diluted with DCM (100 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (100 mL) then brine (100 mL); the organic layer was extracted with CHCl3/IPA (3:2; 2×75 mL), separated, dried over anhydrous sodium sulfate, and concentrated in vacuo to give 1-(2,2-dimethyl-1,3-dioxan-5-yl)azetidin-3-ol (0.626 g, 3.34 mmol, 59% yield) as an amber oil. This was used directly in the next step. MS (ESI, +ve) m/z: 188.1 (M+1)+.

Step 2: 2-(3-HYDROXYAZETIDIN-1-YL)PROPANE-1,3-DIOL

A solution of the crude product from Step 1 and hydrochloric acid (3.38 mL, 16.92 mmol) in tetrahydrofuran (35 mL) was stirred at ambient temperature for 2 h. The reaction mixture was concentrated, dissolved in methanol, and eluted with methanol through a Phenomenex Strata column to give, after concentration, 2-(3-hydroxyazetidin-1-yl)propane-1,3-diol (0.591 g, 4.02 mmol, 71% yield in two steps). ¹H NMR (400 MHz, DMSO-d6) δ 8.37 (br. s., 1H) 6.15 (br. s., 1H) 5.18 (br.s., 1H) 4.40 (t, J=6.6 Hz, 1H) 4.17 (t, J=8.5 Hz, 2H) 3.85 (t, J=8.4 Hz, 2H) 3.44-3.62 (m, 4H) 3.09-3.20 (m, 1H). MS (ESI, +ve) m/z: 148.1 (M+1)+.

2-(2,2-DIMETHYLAZETIDIN-1-YL)PROPANE-1,3-DIOL

Step 1: 1-(2,2-DIMETHYL-1,3-DIOXAN-5-YL)-2,2-DIMETHYLAZETIDINE

Sodium triacetoxyhydroborate (1.63 g, 7.70 mmol) was added to a solution of 2,2-dimethyl-1,3-dioxan-5-one (0.501 g, 3.85 mmol; Matrix Scientific, Columbia, S.C.) and 2,2-dimethylazetidine (0.881 g, 10.35 mmol; Enamine Ltd, Monmouth Jct., N.J.) in dichloromethane (24 mL) and MeOH (3 mL) at ambient temperature. The light yellow solution was stirred at rt for 16 h. The reaction mixture was concentrated, diluted with DCM (100 mL), added to a separatory funnel, and washed with saturated, aqueous sodium bicarbonate (100 mL) then brine (100 mL); the organic layer was extracted with CHCl3/IPA (3:2; 2×75 mL), separated, dried over anhydrous sodium sulfate, and concentrated in vacuo to give 1-(2,2-dimethyl-1,3-dioxan-5-yl)-2,2-dimethylazetidine (0.479 g, 2.40 mmol, 62% yield) as an amber oil. This was used directly in the next step. MS (ESI, +ve) m/z: 200.1 (M+1)+.

Step 2: 2-(2,2-DIMETHYLAZETIDIN-1-YL)PROPANE-1,3-DIOL

A solution of the crude product from Step 1 resulting and hydrochloric acid (5 N aq., 2.31 mL, 11.6 mmol) in tetrahydrofuran (24 mL) was stirred at ambient temperature for 2 h. The reaction mixture was concentrated, dissolved in methanol, and eluted through a Phenomenex Strata column with methanol to give 2-(2,2-dimethylazetidin-1-yl)propane-1,3-diol (0.626 g, 3.93 mmol, 102% yield in two steps). ¹H NMR (400 MHz, DMSO-d6) δ 5.32 (br. s., 2H) 3.92 (br. s., 2H) 3.58 (br. s., 4H) 3.37 (br. s., 4H) 3.25 (t, J=4.7 Hz, 1H) 2.14 (br. s., 2H) 1.61 (s, 6H). MS (ESI, +ve) m/z: 160.1 (M+1)+.

TABLE 1 Examples Prepared by the General Methods MS Example Starting General Data Number Materials Method Product Structure Product Name (M + 1)⁺  3

2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 657.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide  4

2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 657.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide  7

2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 671.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide  8

2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 671.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide  9

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 698.2

(1S,3,6,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 10

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 698.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 11

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 687.2

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino- 1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 12

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 687.2

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino- 1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 13

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 687.2

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino- 1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 14

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 687.2

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino- 1,3-dioxan-2-yl)-6-chloro-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- hydroxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 15

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND 698.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 16

Acetylation

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2r,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND 740.4

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2r,3aR,6aS)-5- acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide

19

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11,12′- dimethyl-7′-(trans-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 20

1

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 726.2

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(cis-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(trans-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 21

1

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 726.2

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(cis-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(trans-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-(1- azetidinyl)-1,3-dioxan-2-yl)-6-chloro-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 22

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR. 740.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(1-pyrrolidinyl)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 24

Reductive amination

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-5- methyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND 712.5

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-5- methyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-5- methyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide AND

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-5- methyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 25

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 701.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 26

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 701.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-methoxy-1,3-dioxan-2-yl)-11′,12′-dimethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 27

Reductive amination

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(ethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 714.3 28

Reductive amination

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 742.3 29

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2S,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 714.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2R,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2R,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2S,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 30

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2S,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 714.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2R,4R)-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2R,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2S,4R)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 31

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 762.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 32

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 762.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3,3-difluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 33

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2S,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 714.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2R,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2R,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2S,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 34

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2S,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 714.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2R,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′- ((2R,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16′18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′- ((2S,4S)-4-((dimethylamino)methyl)-1,3- dioxolan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 35

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 698.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2r,3aR,6aS)-tetrahydro-3aH- [1′3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-((2s,3aR,6aS)-tetrahydro-3aH- [1,3]dioxolo[4,5-c]pyrrol-2-yl)-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 36

Acetylation

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2r,3aR,6aS)-5- acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.4

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2r,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide

37

Acetylation

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 740.4

38

Acetylation

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2r,3aR,6aS)-5- acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.4

(1S,3′R,6′R,7′R,11′S 12′R)-7′-((2r,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide

39

Acetylation

(1S,3′R,6′R,7′S,11′S,12′R)-7′-((2r,3aR,6aS)-5- acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.4

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2r,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-((2s,3aR,6aS)- 5-acetyltetrahydro-3aH-[1,3]dioxolo[4,5- c]pyrrol-2-yl)-6-chloro-11′,12′-dimethyl-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide

40

1

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 716.3

(1S,3′R,6R,7′S,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 47

1 Followed by acetylation

N-(cis-2-((1S,3′R,6′R,7′S,11′S,12′R)-6- chloro-11′,12′-dimethyl-13′,13′-dioxido-15′- oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-7′-yl)-1,3-dioxan-5-yl)-N- methylacetamide OR 764.3

N-(cis-2-((1S,3′R,6′R,TR,11′S,12′R)-6- chloro-11′,12′-dimethyl-13′,13′-dioxido-15′- oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-7′-yl)-1,3-dioxan-5-yl)-N- methylacetamide OR

N-(trans-2-((1S,3′R,6′R,7′S,11′S,12′R)-6- chloro-11′,12′-dimethyl-13′,13′-dioxido-15′- oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-7′-yl)-1,3-dioxan-5-yl)-N- methylacetamide OR

N-(trans-2-((1S,3′R,6′R,TR,11′S,12′R)-6- chloro-11′,12′-dimethyl-13′,13′-dioxido-15′- oxo-3,4-dihydro-2H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-7′-yl)-1,3-dioxan-5-yl)-N- methylacetamide 48

Example 17 & 46

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(methylamino)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 700.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(methylamino)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 49

Examples 17 & 46

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(methylamino)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 700.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(methylamino)-1,3- dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 50

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 744.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 51

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 744.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazateacyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-fluoro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 52

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 756.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 53

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 756.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 54

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 756.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-methoxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 55

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 760.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 56

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 760.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-chloro-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 57

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 742.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 58

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 742.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(diethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 60

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(2-oxa-6-azaspiro[3.3]hept- 6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 768.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(cis-5-(2-oxa-6-azaspiro[3.3]hept- 6-yl)-1,3-dioxan-2-yl)-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(2-oxa-6- azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-11′,12′- dimethyl-7′-(trans-5-(2-oxa-6- azaspiro[3.3]hept-6-yl)-1,3-dioxan-2-yl)-3,4- dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 61

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 742.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 62

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 742.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-hydroxy-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 63

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 754.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 64

1

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or 754.2

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide or

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(2,2-dimethyl-1-azetidinyl)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 65

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-7′,11′,12′- trimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 728.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)- 7′,11′,12′-trimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 66

1 Followed by Reductive amination

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (ethyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 728.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (ethyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(ethyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 67

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-(dimethylamino)-1-azetidinyl)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 769.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-(dimethylamino)-1-azetidinyl)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-(dimethylamino)-1-azetidinyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-(dimethylamino)-1-azetidinyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 68

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (3-(dimethylamino)-1-azetidinyl)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 769.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (3-(dimethylamino)-1-azetidinyl)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-spiro[naphthalene- 1,22′-dihydro-2H,15′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(3-(dimethylamino)-1-azetidinyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(3-(dimethylamino)-1-azetidinyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 69

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (cyclopropyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (cyclopropyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(cyclopropyl(methyl)amino)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(cyclopropyl(methyl)amino)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 70

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (cyclopropyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 740.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (cyclopropyl(methyl)amino)-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(cyclopropyl(methyl)amino)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(cyclopropyl(methyl)amino)-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 71

1 Followed by reductive amination

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- ((2-methoxyethyl)(methyl)amino)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 758.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- ((2-methoxyethyl)(methyl)amino)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-((2-methoxyethyl)(methyl)amino)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-((2-methoxyethyl)(methyl)amino)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 72

1 Followed by reductive amination

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- ((2-methoxyethyl)(methyl)amino)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 758.3

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- ((2-methoxyethyl)(methyl)amino)-1,3-dioxan- 2-yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-((2-methoxyethyl)(methyl)amino)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-((2-methoxyethyl)(methyl)amino)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 73

1

(1S,3′R,6′S,7′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.3

(1S,3′R,6′R,7′R,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′S,7′S,12′R)-6-chloro-7′-(trans-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R.61S,7′R,12′R)-6-chloro-7′-(trans-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 74

1

(1S,3′R,6′S,7′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.3

(1S,3′R,6′R,7′R,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′S,7′S,12′R)-6-chloro-7′-(trans-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′S,7′R,12′R)-6-chloro-7′-(trans-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-ethyl- 3,4-dihydro-2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 75

1

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.2

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 76

1

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.2

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 77

1

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 700.3

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 78

1

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 700.3

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′R,11′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 79

1

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 716.3

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxo[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 80

1

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 716.3

(1S,3′R,6′R,7′S,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(cis-5-amino-5- (hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-7′-(trans-5-amino- 5-(hydroxymethyl)-1,3-dioxan-2-yl)-6-chloro- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 81

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 82

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 758.0

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 83

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- dioxan-2-yl)-12′-(2-methoxyethyl)-11′- methyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 758.0

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′-(2- methoxyethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 84

1

(1S,3′R,6′R,7′S,10′S,11′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.3

(1S,3′R,6′R,7′R,10′S,11′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′S,11′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′S,11′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 85

1

(1S,3′R,6′R,7′S,10′S,11′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 714.3

(1S,3′R,6′R,7′R,10′S,11′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,10′S,11′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,10′S,11′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-10′,11′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 86

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-(hydroxymethyl)-1,3- dioxan-2-yl)-11′,12′-dimethyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 87

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.0

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 88

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.0

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 89

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-methyl-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 728.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-methyl-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-methyl-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-methyl-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 90

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-methyl-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 728.3

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-methyl-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-5-methyl-1,3-dioxan-2-yl)- 11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-5-methyl-1,3-dioxan-2- yl)-11′,12′-dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 91

1

(1S,3′R,6′R,7′S,11′S,12′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.0

(1S,3′R,6′R,7′R,11′S,12′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 92

1

(1S,3′R,6′R,7′S,11′S,12′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 744.0

(1S,3′R,6′R,7′R,11′S,12′S)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′S)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′S)-6-chloro-7′-(trans- 5-(dimethy lamino)-1,3-dioxan-2-yl)-12′- (methoxymethyl)-11′-methyl-3,4-dihydro- 2H,15′H-spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14]diazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 93

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxo[13]thia[1,14,25]triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 715.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25]triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 94

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 715.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide 95

1

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25′triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR 715.2

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(cis-5- (dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25]triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′S,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25]triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide OR

(1S,3′R,6′R,7′R,11′S,12′R)-6-chloro-7′-(trans- 5-(dimethylamino)-1,3-dioxan-2-yl)-11′,12′- dimethyl-3,4-dihydro-2H,15′H- spiro[naphthalene-1,22′- [20]oxa[13]thia[1,14,25]triazatetracyclo [14.7.2.0~3,6~.0~19,24~]pentacosa[16,18,24] trien]-15′-one 13′,13′-dioxide Examples 5 and 23 are intentionally omitted.

Biological Assays

Cell Free Mcl-1: Bim Affinity Assay (Mcl-1 HTRF)

The inhibition of the Mcl-1/Bim interaction was measured using a time-resolved fluorescence resonance energy transfer (TR-FRET) assay. The recombinant human Mcl-1 (C-terminally 6×His tagged Mcl-1 containing residues 171-327) was generated at Amgen Inc (Thousand Oaks, Calif.). A biotinylated peptide derived from human Bim (residues 51-76) was purchased from CPC Scientific (San Jose, Calif.). The TR-FRET assay was conducted in a 384-well white OptiPlate™ (PerkinElmer, Waltham, Mass.) in a total volume of 40 μL. The reaction mixture contained 0.1 nM Mcl-1(171-327), 0.05 nM biotin-Bim(51-76), 0.05 nM LANCER Eu-W1024 Anti-6×His (PerkinElmer), 0.072 nM Streptavidin-Xlent (Cisbio, Bedford, Mass.), and serially diluted test compounds in the binding buffer of 20 mM Hepes, pH 7.5, 150 mM NaCl, 0.016 mM Brij©35, and 1 mM dithiothreitol. Test compounds were pre-incubated with Mcl-1(171-327) and biotin-Bim (51-76) for 60 min before addition of the detection mixture (LANCE Eu-W1024 Anti-6×His and Streptavidin-Xlent). The reaction plates were further incubated overnight and then were read on an Envision® multimode reader (PerkinElmer). Fluorescence signals were measured at 620 nm (40-nm bandwidth) and 665 nm (7.5-nm bandwidth) with a 60 μs delay after excitation at 320 nm (75-nm bandwidth). The signal ratio at 665/620 nm corresponded to the Mcl-1/Bim interaction and was used in all data analyses. The IC₅₀ values of test compounds were determined from duplicate data by analyzing competition curves using a four-parameter sigmoidal model in GraphPad Prism (GraphPad Software, San Diego, Calif.) or in Genedata Screener® (Genedata, Basel, Switzerland).

Cell Viability Assay (OPM-2 10 FBS)

The human multiple myeloma cell line, OPM-2, was cultured in complete growth medium containing RPMI 1640 and 10% fetal bovine serum (FBS). Cells were seeded into 384-well plates at 3000 cells/well density in complete growth medium containing 10% FBS, and incubated for 16 h with serially diluted test compounds in a 37° C. incubator with 5% CO₂. Cell viability was tested using CellTiter-Glo® assay (Promega, Madison, Wis.) according to the manufacturer recommendations. Luminescence was determined using an EnVision® Multilabel plate reader 25 min after the addition of detection reagent. IC₅₀ values were then calculated with Xlfit using a logistical 4-parameter fit model in GraphPad Prism (GraphPad Software, San Diego, Calif.) or in Genedata Screener® (Genedata, Basel, Switzerland).

Results for compounds tested in these biological assays are set forth below. Examples 5 and 23 are intentionally omitted.

Example Mel-1 HTRF IC₅₀ OPM-2 10% FBS Number (μM) IC₅₀ IP (μM)  1 0.000627 0.025  2 0.001601 0.367  3 0.001275 0.926  4 0.001920 2.150  6 0.002092 0.557  7 0.000949 1.070  8 0.001666 7.360  9 0.000490 0.381 10 0.001273 1.115 11 0.00029 0.260 12 0.000382 0.668 13 0.000555 0.635 14 0.000765 1.990 15 0.000765 0.625 16 0.000194 0.262 17 0.000645 0.194 18 0.001370 1.050 19 0.001050 0.527 20 0.000261 0.041 21 0.002035 0.521 22 0.000444 0.065 24 0.000709 0.532 25 0.000473 0.903 26 0.006155 14.60 27 0.000370 0.155 28 0.000477 0.403 29 0.000837 0.317 30 0.005120 2.440 31 0.000374 0.204 32 0.001210 1.940 33 0.0006125 0.319 34 0.011050 5.830 35 0.000829 0.304 36 0.000217 0.169 37 0.000098 0.148 38 0.000537 0.819 39 0.000375 0.578 40 0.000577 1.555 41 0.007990 7.070 42 0.000617 0.217 43 0.000251 0.193 44 0.002075 >33.3 45 0.004680 >33.3 46 0.000340 0.047 47 0.000568 0.545 48 0.000590 0.184 49 0.001517 0.966 50 0.000492 0.126 51 0.000754 1.010 52 0.000267 0.059 53 0.000490 0.184 54 0.001160 0.547 55 0.000742 0.465 56 0.001975 1.900 57 0.000439 0.164 58 0.001350 0.512 59 0.000319 0.090 60 0.000897 0.610 61 0.000455 1.010 62 0.002075 4.470 63 0.002063 1.150 64 0.004895 7.490 65 0.005023 1.560 66 0.001290 0.326 67 0.000347 0.220 68 0.001230 0.517 69 0.000535 0.415 70 0.001310 1.580 71 0.000217 0.090 72 0.000568 0.341 73 0.000657 0.915 74 0.000196 0.108 75 0.012990 6.770 76 0.006235 2.480 77 0.002645 0.595 78 0.002815 0.599 79 0.000704 0.829 80 0.000382 0.240 81 0.003318 2.540 82 0.000175 0.033 83 0.002105 0.540 84 0.000331 0.145 85 0.002064 1.092 86 0.000448 0.178 87 0.005713 0.735 88 0.004365 0.335 89 0.017800 0.729 90 0.000453 0.061 91 0.000184 0.047 92 0.001249 0.988 93 0.000557 0.034 94 0.002660 0.257 95 0.000152 0.108 96 0.000459 0.314 97 0.000308 0.084

The foregoing description is merely illustrative of the invention and is not intended to limit the invention to the disclosed compounds, compositions and methods. Variations and changes, which are obvious to one skilled in the art, are intended to be within the scope and nature of the invention, as defined in the appended claims. From the foregoing description, one skilled in the art can easily ascertain the essential characteristics of this invention, and without departing from the spirit and scope thereof, can make various changes and modifications of the invention to adapt it to various usages and conditions. All patents and other publications recited herein are hereby incorporated by reference in their entireties. 

What is claimed is:
 1. A compound of Formula I:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof, wherein: Z is C or N; b, represented by the symbol

, is a single or double chemical bond which may be cis or trans; R¹ is independently selected from H, halo, C₁₋₆alkylhalo, C₁₋₆alkyl, C₂₋₆alkenyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a),—C(═O)OR^(a), or —C(═O)NR^(a)R^(b); R² is selected from H, halo, C₁₋₆haloalkyl, —C₁₋₆alkyl, —O—C₁₋₆alkyl, —C₂₋₆alkenyl, —C₂-6alkynyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), —C(═O)NR^(a)R^(b), a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, or a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl or heterocycloalkyl group have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may include a C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂; R³ is selected from H, —C₁₋₆alkylhalo, —C₁₋₆alkyl, —C₂₋₆alkenyl, —(CH₂CH₂O)_(n)R^(a), —C(═O)R^(a),—C(═O)OR^(a), or —C(═O)NR^(a)R^(b); each of R^(2B), R^(2C), R⁴, R⁵, R⁶, R⁷, and R⁸ is independently selected from H, halo, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —O—C₁₋₆alkyl, —C₂₋₆alkenyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), —C(═O)NR^(a)R^(b), a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may include a C═O group, and further wherein the spiroheterocycloalkyl and heterocycloalkyl groups may include a S═O or SO₂; alternatively R³ and R⁴ together with the atoms to which they are bonded may form a 5- to 12-membered ring, optionally containing a heteroatom selected from a N, O or S atom, in addition to the S and N atoms present in the ring, wherein the ring may optionally contain at least one double bond; and the ring may be substituted with 0, 1, 2, or 3 R^(3A) substituents; wherein R^(3A) is selected from H, halo, —OH, C₁₋₆haloalkyl, C₁₋₆alkyl, O—C₁₋₆alkyl, C₂₋₆alkenyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —(CH₂CH₂O)_(n)R^(a), —SO₂R^(a), —C(═O)R^(a), —C(═O)OR^(a), —OC(═O)R^(a), or —C(═O)NR^(a)R^(b); each of R^(4A), R^(5A), R^(6A), R^(7A), and R^(8A) is independently selected from H, OH, halo, or —C₁₋₆alkyl; R^(7A) and R^(8A) are absent when b is a double chemical bond; alternatively R⁷ and R⁸ together with the atoms to which they are bonded may form a 3- to 12-membered ring, wherein the ring may optionally contain at least one double bond; R⁹ is independently selected from H, OH, -(═O), —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkenylene, —(CH₂CH₂O)_(n)R^(a), —C(═O)R^(a),—C(═O)OR^(a), —C(═O)NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, cyano, a 6- to 12-membered aryl or heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl or heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, and the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl group may include a C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂; R^(9A) is independently selected from

R^(9B), R^(9C), R^(9D) and R^(9E) are independently selected from H, —OH, halo, cyano, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₂-C₆ alkenyl, —C₂-C₆ alkynyl, —(CH₂CH₂O)_(n)R^(a), —CSR^(a), —CS(═O)R^(a), —SR^(a), —SOR^(a), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —(CH₂)_(n)—NR^(a)R^(b), —NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O—C₁₋₆alkyl-O—C₁₋₆alkyl, phenyl, a 6- to 12-membered monocyclic or bicyclic aryl, a 6- to 12-membered monocyclic or bicyclic heteroaryl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, a 3- to 12-membered cycloalkenyl, a 3- to 12-membered monocyclic or bicyclic cycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the heteroaryl, spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the cycloalkyl, spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may contain a double bond and may contain one or two C═O group, and further wherein the spiroheterocycloalkyl, and heterocycloalkyl groups may include a S═O or SO₂; and still further wherein two adjacent carbon atoms or an adjacent carbon atom and N atom on a R^(9B) heterocycloalkyl group may join together to form a 6-membered aromatic ring that is unsubstituted or is substituted with 1, 2, or 3 R¹³ groups; wherein R^(9D) and R^(9E) together with the atoms they are bonded to, may form a 3- to 12-membered monocyclic or bicyclic ring, optionally containing 1, 2, 3 or 4 heteroatoms independently selected from N, O or S, wherein the ring may contain a double bond, wherein the ring may optionally include a C═O group, and further wherein the ring optionally may be substituted by 1, 2, or 3 R^(9F) substituents; R^(9F) is independently selected from —OH, halo, cyano, —C₁₋₆haloalkyl, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₂-C₆ alkenyl, —C₂-C₆ alkynyl, —(CH₂CH₂O)_(n)R^(a), —CSR^(a), —CS(═O)R^(a), —SR^(a), —SOR^(a), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —(CH₂)_(n)—NR^(a)R^(b), and —NR^(a)R^(b); wherein the aryl, heteroaryl, cycloalkyl, heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl groups of any of the R^(9B), R^(9C), R^(9D), and R^(9E) substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹⁰ substituents independently selected from, OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, —C₂-C₆ alkenyl, —C₂-C₆alkynyl, —OC₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₁₋₆alkyl-O—C₁₋₆alkyl, C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —SO₂R^(c), —CN, —C(═O)NR^(c)R^(d), —C(═O)R^(c), —OC(═O)R^(c), and —C(═O)OR^(c); wherein the C₁₋₆alkyl, C₂₋₆ alkenyl, C₂₋₆ alkynyl and the —OC₁₋₆alkyl of any of the R′, R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, R⁹, R¹⁰, R^(4A), R^(5A), R^(6A), R^(7A), R^(8A), R^(9A), R^(9B), R^(9C), R^(9D) and R^(9F) substituents is unsubstituted or substituted by 1, 2 or 3 R¹¹ substituents independently selected from OH, —OC₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, halo, —O-haloC₁₋₆alkyl, —CN, —NR^(a)R^(b), —(NR^(a)R^(b)R^(c))_(n), —OSO₂R^(a), —SO₂R^(a), —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)R^(a), —OC(═O)R^(a), —C(═O)OR^(a), —C(═O)NR^(a)R^(b), —O—SiR^(a)R^(b)R^(c), and —SiR^(a)R^(b)R^(c); wherein the aryl, heteroaryl, cycloalkyl, heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl group of any of the R², R⁴, R⁵, R⁶, R⁷, R⁸, and R⁹ substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹² substituents independently selected from OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, —OC₁₋₆alkyl,—C₁₋₆alkyl-OH, —C₁₋₆alkyl-O—C₁₋₆alkyl, C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —SO₂R^(c), —CN, —C(═O)NR^(c)R^(d), —C(═O)R^(c), —OC(═O)R^(c), and —C(═O)OR^(c); wherein each R^(a), R^(b), R^(c), and R^(d) is independently H, OH, —C₁₋₆alkyl, —C₂₋₆alkenyl, —C₂₋₆alkynyl, —C₁₋₆alkyl-NR¹³R¹³, —NR¹³R¹³, —SO₂R¹³, —(CH₂CH₂O)_(n)CH₃, -(═O), —C(═O)R¹³, —OC(═O)R¹³, —C(═O)OR¹³, —C(═O)NR¹³R¹³, —C₁₋₆haloalkyl, —O-haloC₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, benzyl, phenyl, —C₁₋₆alkyl-C(═O)OH, —C₁₋₆alkyl-C(═O)—O—C₁₋₆alkyl, —C₁₋₆alkyl-cycloalkyl, C₃₋₆cycloalkyl, and —C₁₋₆alkyl-heterocycloalkyl; R¹³ is independently selected from H, OH, —C₁₋₆alkyl, halo, —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O-haloC₁₋₆alkyl, —CN, —N(—C₁₋₆alkyl)(—C₁₋₆alkyl), —N(—C₁₋₆alkyl)(—C₁₋₆alkyl-O—C₁₋₆alkyl), (CH₂CH₂O)_(n)CH₃, -(═O), —C(═O), —C(═O)—C₁₋₆alkyl, —OC(═O), and —C(═O)O—C₁₋₆alkyl, and wherein n is independently in each instance an integer of 1, 2, 3 or
 4. 2. A compound of Formula IA:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof, wherein: Z is C or N; b, represented by the symbol

, is a single or double chemical bond which may be cis or trans; R¹ is selected from H, halo, or C₁₋₆alkyl; R² is selected from H, halo, or C₁₋₆alkyl; R³ is selected from H or —C₁₋₆alkyl; each of R⁴, R⁵, R⁶, R⁷, and R⁸ is independently selected from H, —C₁₋₆alkyl, —O—C₁₋₆alkyl, or —C₁₋₆alkyl-O—C₁₋₆alkyl; each of R^(4A), R^(5A), R^(6A), R^(7A), and R^(8A) is independently selected from H, or —C₁₋₆alkyl; R^(7A) and R^(8A) are absent when b is a double chemical bond; R⁹ is independently selected from H or —C₁₋₆alkyl; R^(9A) is independently selected from

R^(9B), R^(9C), R^(9D), and R^(9E) are independently selected from H, —OH, —C₁₋₆alkyl, —C₁₋₆alkyl-OH, —(CH₂)_(n)—NR^(a)R^(b), —NR^(a)R^(b), —C₁₋₆alkyl-O—C₁₋₆alkyl, —OC₁₋₆alkyl, —O—C₁₋₆alkyl-O—C₁₋₆alkyl, a 5- to 12-membered spirocycloalkyl or spiroheterocycloalkyl, or a 3- to 12-membered monocyclic or bicyclic heterocycloalkyl group, wherein the spiroheterocycloalkyl and heterocycloalkyl groups have 1, 2, 3 or 4 heteroatoms independently selected from O, N or S, wherein the spirocycloalkyl, spiroheterocycloalkyl, and heterocycloalkyl groups may contain one or two C═O group, and further wherein two adjacent carbon atoms or an adjacent carbon atom and N atom on a R^(9B) heterocycloalkyl group may join together to form a 6-membered aromatic ring that is unsubstituted or is substituted with 1, 2, or 3, R¹³ groups; wherein R^(9D) and R^(9E) together with the atoms they are bonded to, may form a 3- to 12-membered monocyclic or bicyclic ring, optionally containing 1, 2, 3 or 4 heteroatoms independently selected from N, O or S, wherein the ring may contain a double bond, wherein the ring may optionally include a C═O group, and further wherein the ring optionally may be substituted by 1, 2, or 3 R^(9F) substituents; R^(9F) is independently selected from —C₁₋₆alkyl—or C(═O)R^(a); wherein the heterocycloalkyl, spirocycloalkyl and spiroheterocycloalkyl groups of any of the R^(9B), R^(9C), R^(9D) and R^(9E) substituents can be unsubstituted or substituted with 1, 2, 3 or 4 R¹⁰ substituents independently selected from OH, halo, —NR^(c)R^(d), —C₁₋₆alkyl, or —OC₁₋₆alkyl; wherein each R^(a), R^(b), R^(c), and R^(d) is independently H, —C₁₋₆alkyl, —C(═O)NR¹³R¹³, —C₁₋₆alkyl-O—C₁₋₆alkyl, —C₃₋₆cycloalkyl and —C₁₋₆alkyl-heterocycloalkyl; R¹³ is independently selected from H or —C₁₋₆alkyl, and wherein n is independently in each instance an integer of
 1. 3. The compound of claim 1, wherein the compound has the Formula II:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 4. The compound of claim 1, wherein the compound has the Formula IIa:

a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 5. The compound of claim 1, wherein R¹ is halo.
 6. The compound of claim 5, wherein R¹ is C₁.
 7. The compound of claim 1, wherein R³ is H.
 8. The compound of claim 1, wherein R⁴ is independently selected from H, —C₁₋₆alkyl, —C₁₋₆alkyl-O—C₁₋₆alkyl, —C₁₋₆alkyl-OH, —C₁₋₆alkyl-OSO₂CH₃, —C₁₋₆alkyl-phenyl, or —C₁₋₆alkyl-(5-6 membered heterocycloalkyl, having one or two heteroatoms independently selected from N or O).
 9. The compound of claim 8, wherein R⁴ is independently selected from H, —CH₃, —CH₂CH₃, —CH₂—O—CH₃, or —CH₂CH₂—O—CH₃.
 10. The compound of claim 9, wherein R⁴ is —CH₃, —CH₂—O—CH₃′ or —CH₂CH₂—O—CH₃.
 11. The compound of claim 1, wherein R⁵ is selected from H or —C₁₋₆alkyl.
 12. The compound of claim 1, wherein R⁶ is selected from H or —C₁₋₆alkyl.
 13. The compound of claim 1, wherein R⁹ is independently selected from H, or —C₁₋₆alkyl.
 14. The compound of claim 1, wherein R^(9A) is


15. The compound of claim 1, wherein R^(9B) is H, —OH, —C₁₋₆alkyl, OCH₃—NR^(a)R^(b), —CH₂OH,


16. The compound of claim 1, wherein R^(9C) is H, —C₁₋₆alkyl, or —C₁₋₆alkyl-OH.
 17. The compound of claim 1, wherein R^(9A) is


18. The compound of claim 1, wherein R^(9A) is


19. The compound of claim 1, wherein R^(9A) is


20. The compound of claim 1, wherein the compound has the Formula III:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 21. The compound of claim 20, wherein the compound has the Formula IIIa:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 22. The compound of claim 20, wherein R¹ is halo.
 23. The compound of claim 20, wherein R⁴ is —C₁₋₆alkyl.
 24. The compound of claim 20, wherein R⁵ is —C₁₋₆alkyl.
 25. The compound of claim 20, wherein R⁶ is H.
 26. The compound of claim 20, wherein R⁹ is H.
 27. The compound of claim 20, wherein R^(9A) is


28. The compound of claim 1, wherein the compound has the Formula IV:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 29. The compound of claim 28, wherein the compound has the Formula IVa:

or a stereoisomer thereof, a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 30. The compound of claim 28, wherein R¹ is halo.
 31. The compound of claim 28, wherein R⁴ is —C₁₋₆alkyl.
 32. The compound of claim 28, wherein R⁵ is —C₁₋₆alkyl.
 33. The compound of claim 28, wherein R⁶ is H.
 34. The compound of claim 28, wherein R⁹ is H.
 35. The compound of claim 28, wherein R^(9A) is


36. A compound, wherein the compound has a structure selected from:

or a stereoisomer thereof; a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 37. A compound, wherein the compound has a structure selected from:

or a stereoisomer thereof; a pharmaceutically acceptable salt thereof, or a pharmaceutically acceptable salt of the stereoisomer thereof.
 38. The compound of claim 37 or the pharmaceutically acceptable salt thereof.
 39. A pharmaceutical composition comprising the compound of claim 1 or the pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier or diluent.
 40. A method of treating cancer, the method comprising: administering to a patient in need thereof a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein the cancer is selected from leukemia, multiple myeloma, melanoma, or acute myelogenous leukemia.
 41. The method of claim 40, wherein the cancer is acute myelogenous leukemia.
 42. The method of claim 40, wherein the cancer is leukemia.
 43. The method of claim 40, wherein the cancer is multiple myeloma.
 44. The method of claim 40, further comprising administering to the patient in need thereof a therapeutically effective amount of an additional pharmaceutically active compound.
 45. The method of claim 44, wherein the additional pharmaceutically active compound is carfilzomib, venetoclax, or cytarabine. 